Originally Posted by Carbonfiberboy

Updating my post 9 from 2-18-21. I had the scan to which I was referring in 2017. I actually don't remember what the exact number was, only that it was in the High realm, which scared me.
What I've learned since:
High calcium scores in endurance athletes are the result of heart inflammation which happens at prolonged high exertion levels. It's a U shaped curve: high levels of exertion are as dangerous as low levels. The CDC has located the sweet spot on the curve: Moderate exercise levels decrease inflammation, high levels increase it. The result of the inflammation caused by high exercise levels are not only atherosclerosis, but also A-fib and electrical blocks in the heart.

So it all depends on what you want out of life, You can't have it all. My choice was to continue riding hard and long. The result so far was 3 stents, one minor heart attack and internal heart blocks so that now I have a pacemaker. I sure had fun though! I am very thankful I live in this age because I'm not dead. So you take your choice and see what happens.

I had my first syncope (passing out) in October '22. It took a year for my 3 cardiologists to figure out what was wrong with me and fix it. While they were working on it, I got my stents and that heart attack. The problem was that very few cardiologists know anything at all about the aging athlete. Almost all of their practice is with folks who've ignored diet, exercise, and their bodies. When I started seeing these doctors they were clueless about what was wrong with my heart, even months into the process. I appeared to them to have the physiology of a mid-40s healthy guy, though I was 77. They said, "Oh you're fine, go home."

The good part, which starts as the bad part: When I couldn't tolerate a statin in '17, my cardiologist said, "Too bad." He was unaware (probably wasn't reading his journals, like many doctors) that a new cholesterol lowering drug was on the market, Repatha. My current cardiologists finally figured out that I had serious coronary blockages only because I insisted on having an angiogram, which turned into an angioplasty in the OR - I got stents. They had been quite resistant. Athlete's heart again, working much better than it should have been able to. Unfortunately the cardiologist missed one and I had a heart attack anyway a few months later, got a third stent. The good part is that I finally got a prescription for Repatha, which could have saved me all this trauma. It not only lowers LDL, it also reduces heart inflammation by reducing the inflation-causing cytokines and IL variations.

Now I'm on a long road to recover fitness and I'm hopeful, like always.