u/Loud_Ticket_9910

No mention in the diagnosis so I'm confused.

What do the 3 LV pressures indicate?

Is the 32-33 a very high LVEDP? Or is it 5?

UPDATE: Insurance approved Repatha! just took first shot.

49m 5'9" 255lbs (down from 330) High CAC of 463 focal to distal RCA. I had a second CAC and came out Zero, (that spiked my Dr's interest!) due to failure to lower heart rate during CCTA so this prompted getting a regular femoral catheter coronary angiogram.

Non-smoker or heavy drinker, did smoke socially in college but never full on continuous habit. Only drink a couple times a month wine or similar with dinner.

Dr put me on Baby Aspirin, Telmisartan, Nebivolol, Tadalafil, Synjardy along with Zetia and Repatha (we're awaiting approval for).

I'm also on HRT for the past 6mo or so due to primary hypogonadism.

The Report they gave me does not mention the elevated LVEDP but in my discussion with my cardiologist he noted it from the pressures.

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From the report:

"Diagnostic Findings

* Left main has no disease.

* Left anterior descending has no disease.

* Proximal Circumflex: minimal 30% stenosis, TIMI: 3 flow.

Mid Right Coronary Artery to Distal Right Coronary Artery: minimal 30% stenosis, TIMI: 3 flow.

* Coronary angiography shows right dominance.

Ventriculography

Ejection Fraction: 60%

Conclusions

1. There is minimal coronary artery disease with two vessel disease.
2. Normal left ventricular systolic function. Ejection fraction of 60%.

Recommendations

Aggressive medical therapy for coronary artery disease."

###

Lipids are good but I'm switching to Repatha (hoping for approval) due to severe statin myalgia and other sides.

hsCRP is 2.2 and HDL went down for some reason so room for improvement.

Lipid Marker	March 16, 2026	February 14, 2026	Reference Range	Status
Total Cholesterol (mg/dL)	94.0 [1]	112.0 [2]	140 – 200	Optimal
Triglycerides (mg/dL)	49.0 [1]	65.0 [2]	35 – 160	Optimal
HDL Cholesterol (mg/dL)	36.0 [1]	47.0 [2]	35 – 60	Acceptable
LDL Cholesterol (mg/dL)	48.2 [1]	52.0 [2]	< 100	Optimal
VLDL Cholesterol (mg/dL)	9.8 [1]	13.0 [2]	5 – 30	Optimal
Apolipoprotein B (mg/dL)	—	57 [3]	< 90	Optimal
Lipoprotein (a) (nmol/L)	—	11 [4]	< 75	Optimal

Dr said, just keep losing weight, take your meds, eat right and exercise and all be fine.

Thoughts?

Sorry for the long post...

FALSE ZERO CAC SCORES WARNING

I have several posts about this saga that you can see if curious. I'll post a TLDR version here.

Dec 2025: 463 CAC Score localized to distal RCA.

Feb 2026: at a different facility, attempted CCTA twice, aborted due to high RHR non responsive to beta blockers. Repeated CAC score instead, result ZERO!

Cardiologist dumbfounded, impossible to have a Zero CAC 2 months after a high risk CAC, cardiac catheterization ordered, results in pics.

APRIL 27th 2026: Femoral catheter coronary angiogram performed

Contrast: OMNIPAQUE 350

* Amount (mL): 52 ml

Diagnostic Findings

* Left main has no disease.

* Left anterior descending has no disease.

* Proximal Circumflex: minimal 30% stenosis, TIMI: 3 flow.

* Mid Right Coronary Artery to Distal Right Coronary Artery: minimal 30% stenosis, TIMI: 3 flow.

* Coronary angiography shows right dominance.

Ventriculography

Ejection Fraction: 60%

Conclusions

1. There is minimal coronary artery disease with two vessel disease.
2. Normal left ventricular systolic function. Ejection fraction of 60%.

Recommendations

* Aggressive medical therapy for coronary artery disease.