Know Your Score

Dear Family & Friends,

Thank you so much for your prayers, cards, texts, love and support during this most painful time of loss in my life .

As many of you may have heard, my sweet 53-year-old brother, Michael, suffered a cardiac arrest on March 23, 2026, at the gym he co-owned in Katonah, NY.

Thanks to the heroic efforts of those at the gym—who immediately performed CPR and used an AED—his pulse was restored. When he arrived at Northern Westchester Hospital in Mount Kisco, he was taken to the cardiac cath lab, where he underwent an emergent procedure to place a stent in his left anterior descending (LAD) artery, which was 99% blocked. The LAD is often referred to as “the widowmaker.”

He received truly exceptional care in the ICU. Despite every effort, however, he suffered a severe anoxic brain injury that was irreversible. Michael was an organ donor, and in his passing on March 30, 2026, he continued to give selflessly. He was honored with a beautiful “Honor Walk,” where hospital staff line the halls to pay tribute to an organ donor as they are taken to the operating room. In my 35+ years in medicine, it was one of the most moving and meaningful experiences I have ever witnessed.

What makes this even more heartbreaking is that Michael had no known risk factors for coronary artery disease (CAD). No family history—our father lived to 92, and our mother is 91 and thriving. He had no diabetes, no hypertension, never smoked, used no drugs, and took no medications for cholesterol or any chronic condition. He was, quite simply, the healthiest among us and deeply committed to his fitness—second only to his faith, as he also served as a pastor.

For several years, I had encouraged him to get a CT calcium score and additional biomarkers as a baseline screening. Like many of us, he was busy—and because he was so healthy and uber fit, he postponed it, planning to do it this year with his annual checkup appointment.

There are no words to fully express the profound sadness and loss we feel. But if someone as healthy as my brother can develop severe coronary artery disease, it raises an important question: who among us is truly not at risk?

Heart disease remains the leading cause of death both in the United States and worldwide, yet we do not have a widely adopted routine screening test for it.

We routinely screen for other diseases:

• Colonoscopies for colon cancer
• Pap smears for cervical cancer
• PSA testing for prostate cancer
• Mammograms for breast cancer
• CT scans for lung cancer in long-term smokers

But we lack a standard screening approach for the #1 cause of mortality in America and globally —heart disease.

It doesn’t make sense.

Primary care physicians may not always order advanced cardiac screening if you are considered “low risk.” But we screen for many conditions even in people without obvious risk factors—so why not this?

After speaking with several cardiology colleagues, there is agreement that screening should be more widely considered.

However, at this time, there is not a 100% perfect test to rule out coronary artery disease that is affordable & noninvasive.

However, if you are 40 or older and asymptomatic, one of the most useful screening tools that can give one insight into their cardiovascular health is a CT Coronary Calcium score. This is a quick, non-invasive scan (about 5–15 minutes), requires no IV or preparation, and typically costs $100–$150 out of pocket, as it is not usually covered by insurance.

A physician’s order is required.

If you have a family history of heart attacks or sudden cardiac death at a young age or conditions like familial hypercholesterolemia, you should consider a full evaluation by a cardiologist.

While it’s true that a score of zero on your CT Calcium score is reassuring, particularly in older individuals, it does not mean you do not have heart disease.

Why? Because the CT Calcium score scan only detects calcified plaque, not non-calcified (soft) plaque, which can be equally dangerous. In fact, calcified plaques are often more stable than soft plaques, which are prone to rupture, and a major cause of acute heart attack or cardiac arrest. So, in younger populations, soft plaque may be present without having had time to calcify and so you will not see this on a CT Calcium score test.

So, how often should you have a calcium score test? You may see a benefit from having a CT Calcium Score test every three to five years, according to studies. It’s only helpful to repeat a scan if you had a normal score the first time and want to know if your risk is still low. It’s not helpful to repeat the CT Calcium score test if you had an abnormal result the first time, since you will need to go to a cardiologist for further evaluation and they will perform other cardiac testing on you.

In addition to a standard lipid panel, ask your doctor to order these advanced markers to better assess your cardiovascular risk and stroke risks:

• Apolipoprotein B
• Lipoprotein A - Lp(a) this is a genetic marker so you only have this done once in a lifetime
• ADMA/SDMA
• hs-CRP (this is different than just regular CRP)

If you have risk factors: Diabetes, pre-diabetes, hypertension, elevated cholesterol/LDL or elevation of any of the biomarkers mentioned above, present or past smoker,positive family history of heart disease, overweight with BMI over 25 or more, or a sedentary lifestyle---I would definitely get the CT calcium score knowing the absence of calcium indicates a low risk in the short term, but it cannot fully rule out the presence of atherosclerosis or future events—especially when other risk factors like high LDL, smoking, hypertension,or diabetes, +family history for CAD are present.----but having more information about your cardiovascular risk is important in preventing further progression of heart disease by modifying your lifestyle, diet, exercise, being placed on lipid lowering medications like statins, etc

Please take the time to educate yourselves—Knowledge is Power.

Advocate for your health and for those you love.

“Know your Score.” ❤️

Peace🙏

Vi

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