ArcaMax

DEAR DR. ROACH: I recently had a CT scan of my chest and abdomen for pain, and they made a note that I also had coronary atherosclerosis. What is this condition? Can medications help? Can it be treated without surgery? -- P.D.

ANSWER: A computed tomography (CT) scan gives multiple two-dimensional slices of the body and is very good at looking at many medical issues. Modern CT scanners are so good that they can find calcium depositions inside major blood vessels.

In your case, they found calcium inside one or more of the blood vessels of your heart. There are dedicated scanners that work quickly enough to "freeze" the heart motion so that the amount of calcium in the blood vessels can be numerically scored. But even a regular chest CT scan can often find calcium in the heart vessels.

Calcium in the arteries does not always mean blockages in the blood vessels. Sometimes there is calcium in the outside of the blood vessels without any cholesterol plaque inside the blood vessels. The higher the calcium score, the more likely it is that there are blockages. Blockages in the blood vessels of the heart are diagnostic of coronary atherosclerosis, and almost all heart attacks comes from this condition.

Medications can absolutely help reduce the risk of a heart attack. Most people with coronary atherosclerosis benefit from a statin drug, which helps stabilize plaque and prevent rupture (the beginning of a heart attack). Aspirin helps prevent a blood clot, which blocks blood flow to the heart and, in turn, leads to heart muscle cells dying (the essence of a heart attack). Other medications, including beta blockers and sometimes ACE inhibitors, are also used to prevent heart attacks.

The medications we have now are so good that far fewer people undergo surgery (a coronary artery bypass graft) than they used to a few decades ago. If you haven't seen your regular doctor, they (or a cardiologist) can help decide which medication regimen is best for you. They can also help you with the best diet and exercise regimen to reduce your risk.

DEAR DR. ROACH: Are there any benefits to taking curcumin daily or any concerns about the side effects? I have read that some brands can contain harmful additives, including lead. -- A.A.

ANSWER: Curcumin, the most active ingredient in turmeric, has been used as a spice and medication for many years. Most turmeric (80% of the world's supply) comes from India, Pakistan, Sri Lanka and Nepal.

A 2024 study found a large proportion of the turmeric sold in Pakistan and the state of Bihar, India, was contaminated by lead chromate, which makes the spice bright yellow. I want to emphasize that the high level of lead contamination was found in bulk packages that were sold in those countries, not what is sold as spice or as a supplement in the United States.

There have been cases of turmeric that were sold in the U.S. and were adulterated by lead, but these have been decreasing since 2017.

The best way of being sure that you are getting lead-free curcumin or turmeric is through third-party lab testing. Curcumin is shown to be helpful for various conditions but most especially with arthritis. The most common side effect I see is diarrhea.

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Dr. Roach regrets that he is unable to answer individual letters, but will incorporate them in the column whenever possible. Readers may email questions to ToYourGoodHealth@med.cornell.edu or send mail to 628 Virginia Dr., Orlando, FL 32803.

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