If you’ve had a positive calcium score (CAC score), you’ve probably asked the obvious next question: when should I repeat it?

In this video, I explain why I generally do not order another calcium score if the first one is positive—and what I prefer to use instead to follow atherosclerosis over time.

We walk through what a coronary artery calcium score actually measures, why it’s really just the tip of the iceberg, and why a higher repeat score does not necessarily mean your treatment failed. I also explain the difference between calcified plaque and soft, lipid-rich plaque, why that distinction matters for heart attack and stroke risk, and why serial CAC testing often adds less useful information than people think.

I also cover:
• why calcium scores can be helpful as a one-time risk assessment tool
• why I’m more cautious about relying on CAC in younger patients
• when I will repeat a calcium score
• why I prefer more informative tools like CCTA and CIMT for tracking disease over time

If you’re trying to understand calcium score progression, plaque stabilization, soft plaque, coronary artery disease, heart disease prevention, stroke prevention, ApoB, Lp(a), statins, and cardiovascular risk, this video is for you.

Let me know in the comments: If your first calcium score was positive, would you want to repeat it—or would you rather use a different test to follow your risk?

#CalciumScore #CACScore #HeartDiseasePrevention #Atherosclerosis #CardiovascularHealth #CIMT #CCTA

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🧬 About Dr. Lily Johnston

Dr. Johnston is a double board-certified vascular and general surgeon in San Diego, specializing in metabolic and cardiovascular prevention. She’s the founder of CorSight Health and a passionate advocate for reimagining how medicine approaches chronic disease.

#MetabolicHealth #CardiovascularPrevention #HeartHealth #Longevity #InsulinResistance #DrLilyJohnston #DrLily #WomenInMedicine #Surgeon #VascularSurgeon #PreventiveMedicine #PADPrevention #HeartAttackRisks #HealthPortfolio #California #SanDiego #Arizona #Virginia #Minnesota