Hi Karen.
Sorry to hear about all these issues.
Have you had your Lp(a) tested? Having elevated Lp(a) is known to cause early cardio vascular disease, which would be reflected in a high calcium score. Also, elevated Lp(a) is known to be strongly associated with valvular calcification. In fact, it is estimated that for about 1 out of 7 patients with aortic stenosis the cause is elevated Lp(a). In that you are not bicuspid, yet you have aortic stenosis, and in that you have a very high calcium score, I would strongly suggest getting your Lp(a) checked.
Although cardiologists are gradually becoming more educated about Lp(a), for most of them this is still a blind spot. If it turns out that you have high Lp(a), nothing can be done to change the fact that you need surgery for your aortic stenosis, but it would be an important thing to be aware of long term, as there are some theraputics in the pipeline, with expected FDA approval in about 2025.
Your insurance should pay for Lp(a) testing. If you go to Quest Diagnostics, Lp(a) is included in their advanced lipid panel. LabCorp still does not include Lp(a) in their advanced panel, but you can still order an individual test from either lab for about $ 40 to $55. Even if insurance won't cover it, I would suggest it is worth paying for this test.
Please see links below:
Lp(a) and aortic stenosis:
"What is the evidence we have for Lp(a) as a risk factor for aortic valve stenosis? The epidemiological and genetic evidence is quite strong that high Lp(a) is associated with the development of aortic valve stenosis. Lp(a) is an important carrier of oxidized phospholipids which are considered as an key culprit for the development of aortic valve stenosis."
https://academic.oup.com/eurheartj/article/43/39/3968/6670979
Lp(a) and heart disease and strokes:"
- Like LDL-cholesterol, Lp(a)-cholesterol can build up in the walls of your blood vessels. The higher your Lp(a) level is, the more likely this is to happen. These cholesterol deposits, called plaques, can decrease blood flow to your heart, brain, kidneys, lungs, legs, and other parts of your body. Plaques can grow over time or suddenly rupture, blocking blood vessels and leading to heart attacks or strokes.2
- Lp(a) can cause increased clotting, which can lead to rapidly formed blockages in blood vessels.2
- Lp(a) promotes inflammation which increases the likelihood that plaques will rupture.2
https://www.cdc.gov/genomics/diseas...) structure,,signs of coronary heart disease.