# Totally OT: The mystery of Lp(a) **URL:** \ **Category:** Macro Economic Trends and Risks\ **Created:** [September 24, 2024, 3:52pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002 "2024-09-24T15:52:50Z")\ **Posts on this page:** 18\ **Page:** 1
**Author:** ![WendyBG](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/wendybg/32/67464_2.png) [@WendyBG](https://discussion.fool.com/u/WendyBG)\ **Post date:** [September 24, 2024, 3:52pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/1 "2024-09-24T15:52:50Z")
I apologize to METARs for cluttering up the board with OT messages about health. I became interested in Lp(a) when I learned that high Lp(a) could infiltrate the heart valve flap and literally cause it to manufacture bone. Weird but true. So I got a blood test. My Lp(a) level is 9 nmol/L while \< 75 nmol/L is considered optimal. So I’m mystified as to why my aortic valve became calcified. Next stop: angiogram on October 16. Wendy ---
**Author:** ![steve203](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/steve203/32/3302_2.png) [@steve203](https://discussion.fool.com/u/steve203)\ **Post date:** [September 24, 2024, 4:33pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/2 "2024-09-24T16:33:10Z")
> [@WendyBG](#): > > So I’m mystified as to why my aortic valve became calcified. You aren’t a teenager anymore? My neighbor, who is about the same age as you and I, went in for open heart surgery a couple weeks ago. I don’t know what his specific issue was. Steve ---
**Author:** ![Leap1](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/leap1/32/72176_2.png) [@Leap1](https://discussion.fool.com/u/Leap1)\ **Post date:** [September 24, 2024, 5:17pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/3 "2024-09-24T17:17:14Z")
> [@WendyBG](#): > > So I’m mystified as to why my aortic valve became calcified. Dad as a doctor was more interested in what than why. Something can be done with what. Nothing now can be done with why. It is often a misnomer that why would do something. I expect you have led a mostly healthy lifestyle. Any combination of DNA and environment. Unknown. ---
**Author:** ![JimA759s](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/jima759s/32/2844_2.png) [@JimA759s](https://discussion.fool.com/u/JimA759s)\ **Post date:** [September 24, 2024, 10:28pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/4 "2024-09-24T22:28:11Z")
> [@WendyBG](#): > > My Lp(a) level is 9 nmol/L while \< 75 nmol/L is considered optimal. Not sure how to convert the numbers; but my lab test showed 64mg/dl and the standard was \<= 29mg/dl. So I’m above average; my mother would be so proud! JimA ---
**Author:** ![VeeEnn](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/veeenn/32/3379_2.png) [@VeeEnn](https://discussion.fool.com/u/VeeEnn)\ **Post date:** [September 25, 2024, 12:13am UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/5 "2024-09-25T00:13:15Z")
> [@Leap1](#): > > > [@WendyBG](#): > > > > So I’m mystified as to why my aortic valve became calcified. > > Dad as a doctor was more interested in what than why. **Something can be done with what.** That’s thinking for 1900’s medicine. Sorry, but the technology around in your dad’s day oftentimes didn’t allow for any understanding of “why”…which is oftentimes the reason that trying to treat the “what” without that understanding was unsuccessful. For instance, and in the context of “heart disease”…it’s still the World’s #1 cause if premature death. ---
**Author:** ![Leap1](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/leap1/32/72176_2.png) [@Leap1](https://discussion.fool.com/u/Leap1)\ **Post date:** [September 25, 2024, 12:41am UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/6 "2024-09-25T00:41:07Z")
That’s partially true, things haven’t changed. Wendy can get whys but she won’t know which why to apply. Her doctors won’t know usually which why to apply. The whys will come often from fictions by Ph.Ds. Good luck obsessing over why. What is still what it is and what can be treated. You did not explain the why sufficiently of heart disease. Lifetime habits, lack of care…ok but that does not apply to Wendy. Why does not have to matter folks just get the care you need. ---
**Author:** ![rainphakir](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/rainphakir/32/1497_2.png) [@rainphakir](https://discussion.fool.com/u/rainphakir)\ **Post date:** [September 25, 2024, 3:24am UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/7 "2024-09-25T03:24:09Z")
> [@WendyBG](#): > > So I’m mystified as to why my aortic valve became calcified. Here’s a possibility? [https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522) {{ Bone Formation and Inflammation in Cardiac Valves OTHER Originally Published 20 March 2001 Free Access # Bone Formation and Inflammation in Cardiac Valves [Emile R. Mohler, III](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#con1), [Francis Gannon](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#con2), [Carol Reynolds](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#con3), [Robert Zimmerman](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#con4), [Martin G. Keane](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#con5), and [Frederick S. Kaplan](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#con6)[AUTHOR INFO & AFFILIATIONS](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#tab-contributors) Circulation [Volume 103, Number 11](https://www.ahajournals.org/toc/circ/103/11) [https://doi.org/10.1161/01.CIR.103.11.1522](https://doi.org/10.1161/01.CIR.103.11.1522) [25,847744](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#) ### Metrics ### Total Downloads25,847 - Last 12 Months1,167 ### Total Citations744 - Last 12 Months26 [TRACK CITATIONS](https://www.ahajournals.org/action/addCitationAlert?doi=10.1161%2F01.CIR.103.11.1522)[ADD TO FAVORITES](https://www.ahajournals.org/personalize/addFavoritePublication?doi=10.1161%2F01.CIR.103.11.1522) [PDF/EPUB](https://www.ahajournals.org/doi/reader/10.1161/01.CIR.103.11.1522) - - [Abstract](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#abstract) - [Methods](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#sec-1) - [Results](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#sec-2) - [Discussion](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#sec-3) - [Acknowledgments](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#acknowledgments) - [Footnote](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#footnotes) - [References](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#bibliography) - [eLetters](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#comments) - - [Information & Authors](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#core-collateral-info) - [Metrics & Citations](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#core-collateral-metrics) - [View Options](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#core-collateral-fulltext-options) - [References](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#core-collateral-references) - [Media](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#core-collateral-media) - [Tables](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#core-collateral-tables) - [Share](https://www.ahajournals.org/doi/10.1161/01.CIR.103.11.1522#core-collateral-share) ## Abstract _Background_—For nearly a century, the mechanical failure of calcified heart valves was attributed to a passive degenerative process. Recently, several case reports described bone formation in surgically excised heart valves and suggested an unexpected process of tissue repair. _Methods and Results_—We studied the prevalence and pathology of heterotopic ossification in 347 surgically excised heart valves (256 aortic, 91 mitral) in 324 consecutive patients (182 men, 142 women; mean age 68 years) who underwent cardiac valve replacement surgery between 1994 and 1998. The valves were examined microscopically to determine the prevalence and features of bone formation and remodeling. Two hundred eighty-eight valves (83%) had dystrophic calcification. Mature lamellar bone with hematopoietic elements and active bone remodeling were present in 36 valves (13%) with dystrophic calcification. Endochondral bone formation, similar to that seen in normal fracture repair, was identified in 4 valves. Microfractures were present in 92% of all valves with ossification. Neoangiogenesis was found in all valves with ossification. Bone morphogenetic proteins 2 and 4 (BMP 2/4), potent osteogenic morphogens, were expressed by myofibroblasts and preosteoblasts in areas adjacent to B- and T-lymphocyte infiltration in valves where ossification was identified. Mast cells were present in calcified and ossified valves and were especially prominent in atheromatous regions. **_Conclusions_—Heterotopic ossification consisting of mature lamellar bone formation and active bone remodeling is a relatively common and unexpected finding in end-stage valvular heart disease and may be associated with repair of pathological microfractures in calcified cardiac valves**. }} The valves are “sheets” of collagen tissue, similar to fascia. It’s NOT fascia… But similar. There are more layers and cells, too. In general, there are cells in the matrix of valves that maintain and repair the collagen connective tissue that makes up the heart valves. These cells usually produce collagen and associated “tissues”. In some cases, apparently these “maintenance cells” get reprogrammed to include “bone matrix” as part of that repair process. At least that’s how I read the ABSTRACT for that study. TLDR the whole thing 🙂. **Speculation** : viruses cause “long effects”. Bacteria cause some heart valve problems. **Speculation** Perhaps a virus or bacteria from a past infection triggered the “maintenance cells” in the heart valve to begin capturing Ca and laying it down in the valve matrix? Are you experiencing calcification in other tissues? Tendons, ligaments, sheaths, fascia, etc? Bone spurs? Calcium deposits where they aren’t supposed to be? 🤔 ralph The comments above are not medical advice. 🙂 ---
**Author:** ![VeeEnn](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/veeenn/32/3379_2.png) [@VeeEnn](https://discussion.fool.com/u/VeeEnn)\ **Post date:** [September 25, 2024, 11:35am UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/8 "2024-09-25T11:35:44Z")
> [@Leap1](#): > > Good luck **obsessing over why.** > > What is still what it is and what can be treated. I guess, what you’re demonstrating is the difference between the intellectually curious mind…and the “not”. I’d say that wondering about observations that don’t fit a typical picture is a long way from _ **obsessing over** _. It’s what’s moved scientific discovery forward…and on an individual level, encourages medical practitioners to evolve in their practices. I’ve mentioned before that my primary care physician/practice has appeared to change after my experience with my CAC scan result after previous reassurances over my lipid profile/healthy lifestyle. Their newsletter has had quite a few references to this test as an adjunct to decision making when warranted (and it’s probably warranted far more frequently than it’s utilised) My primary care physician also noted on our last visit that she had every intention of using her stethoscope on EVERY patient…even Medicare beneficiaries (as the “wellness check” that is substituted for the “annual physical” apparently doesn’t call for it) This was in the context of picking up dh’s _newly emergent_ heart murmer during a thought to be routine annual visit. The “why’s” to answer in these two instances (Wendy’s and mine…advanced aortic stenosis and coronary artery disease do NOT develop overnight) are _ **why did two patients have underlying diseases develop unnoticed when the tools for early detection were readily available along with a regular opportunity to use them?** _ … and … _ **did the appearance of the healthy phenotype/Good Custodian provide a smokescreen to timely diagnosis** _. In the context of other threads on the impact of the obesity epidemic, this is one cost that’s born by the individual who _does_ make an effort to take care of themselves properly…their issues get shoved aside by others’ bad habits. ---
**Author:** ![Leap1](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/leap1/32/72176_2.png) [@Leap1](https://discussion.fool.com/u/Leap1)\ **Post date:** [September 25, 2024, 2:12pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/9 "2024-09-25T14:12:50Z")
> [@VeeEnn](#): > > I guess, what you’re demonstrating is the difference between the intellectually curious mind…and the “not”. You constantly need to make assumptions that are not warranted. Finding out what is more than a full time job. The problem with the rest of your post, your dh’s and Wendy’s doctors do not know why. You have not told us the why. Your post was vacuous. Why is a personal need all of us have. It does not answer what to do. It is often undiscoverable. Yes someone with poor lifestyle habits needs to change. That still does not specifically answer why. It is okay not to know why. Medical people create ideals they never meet. A doctor who works well with what is more effective. ---
**Author:** ![WendyBG](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/wendybg/32/67464_2.png) [@WendyBG](https://discussion.fool.com/u/WendyBG)\ **Post date:** [September 25, 2024, 2:25pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/10 "2024-09-25T14:25:45Z")
> [@rainphakir](#): > > Are you experiencing calcification in other tissues? Tendons, ligaments, sheaths, fascia, etc? > Bone spurs? > Calcium deposits where they aren’t supposed to be? @rainphakir thanks for your fascinating research. I wish there was a “super-rec” because you post was worth 10 of most ordinary rec’d posts. I have Posterior Tibial Tendon Disorder (PTTD) in both ankles. Is this painful failure of the tendon (collagen) that holds up the arch of the foot related to my aortic valve problem? Hmmm… Wendy ---
**Author:** ![Leap1](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/leap1/32/72176_2.png) [@Leap1](https://discussion.fool.com/u/Leap1)\ **Post date:** [September 25, 2024, 2:45pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/11 "2024-09-25T14:45:33Z")
> [@rainphakir](#): > > The valves are “sheets” of collagen tissue, similar to fascia. It’s NOT fascia… But similar. > There are more layers and cells, too. > > In general, there are cells in the matrix of valves that maintain and repair the collagen connective tissue that makes up the heart valves. > > These cells usually produce collagen and associated “tissues”. > In some cases, apparently these “maintenance cells” get reprogrammed to include “bone matrix” as part of that repair process. The body is supposed to create collagen. That is how I read that. I worry that as we substitute for bodily processes the body ceases to do things properly for itself. In this case that is an unknown. The fountain of youth backfires. adding All sources say the supplements enhance the production of collagen. @WendyBG This is concerning to me. **This though is a potential problem** **Hypercalcemia** **Collagen supplements can cause an excess of calcium, which can lead to an abnormal heart rhythm.** Separate quick look up Hypercalcemia, or high calcium levels, can lead to heart valve problems, including aortic valve sclerosis and aortic valve stenosis. Aortic valve sclerosis is a condition that causes the aortic valve to thicken and stiffen, which can lead to aortic valve stenosis. Aortic valve stenosis can reduce blood flow from the left ventricle to the aorta, and may require surgery or other treatments to replace or fix the valve. Treatments for hypercalcemia include: - Electrolyte replacement Correcting other electrolyte abnormalities, such as hypokalemia, hypomagnesemia, and hypophosphatemia - Renal replacement therapy A low- or no-calcium bath for patients with severe hypercalcemia and renal failure - IV fluids and loop diuretics Quickly lowering calcium levels to prevent heart rhythm problems and nervous system damage - Surgery Removing an overactive parathyroid gland if hypercalcemia is caused by that gland - Medications Depending on the cause of hypercalcemia, medications may be prescribed Hypercalcemia can be caused by a number of conditions, including malignancy, primary hyperparathyroidism, autoimmune disorders, and granulomatous diseases. ---
**Author:** ![VeeEnn](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/veeenn/32/3379_2.png) [@VeeEnn](https://discussion.fool.com/u/VeeEnn)\ **Post date:** [September 25, 2024, 4:40pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/12 "2024-09-25T16:40:28Z")
Considering that calcium levels are routinely measured and recorded on a comprehensive metabolic panel, the question “why” arises…as in why would anyone think a chronic, serious medical condition might apply in this case based on a quick look up? I’m reasonably sure that Wendy gives her annual bloodwork at least a quick eyeball and would notice something that would be flagged red…and wonder “why” herself. ---
**Author:** ![JLC](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/jlc/32/1338_2.png) [@JLC](https://discussion.fool.com/u/JLC)\ **Post date:** [September 25, 2024, 6:43pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/13 "2024-09-25T18:43:52Z")
> [@WendyBG](#): > > So I’m mystified as to why my aortic valve became calcified. IIRC, you said your aortic valve is bicuspid (two leafed) instead of the normal tricuspid (three leafed). More turbulence, more stress on leaflets, plus a lifetime. ---
**Author:** ![Leap1](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/leap1/32/72176_2.png) [@Leap1](https://discussion.fool.com/u/Leap1)\ **Post date:** [September 25, 2024, 8:10pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/14 "2024-09-25T20:10:33Z")
> [@VeeEnn](#): > > quick look up? Stop being dense. “Separate quick lookup”. Stop dragging down conversations. Stop taking a whack at me because you are not a medical doctor. You do not listen to medical doctors unless it is an inapplicable PODcast. Calcium in the blood may have been measured but on the surface of the valve, it was not measured. The issue is on the cellular level. My arteries have a thin bit of calcium. The blood level of calcium is not raised. > [@Leap1](#): > > **This though is a potential problem** > > **Hypercalcemia** > > **Collagen supplements can cause an excess of calcium, which can lead to an abnormal heart rhythm.** This is a possible issue. You skipped it in your summation of what I said. Read damn it. Read. ---
**Author:** ![VeeEnn](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/veeenn/32/3379_2.png) [@VeeEnn](https://discussion.fool.com/u/VeeEnn)\ **Post date:** [September 25, 2024, 9:48pm UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/15 "2024-09-25T21:48:38Z")
> [@WendyBG](#): > > @rainphakir thanks for your fascinating research. I wish there was a “super-rec” because you post was worth 10 of most ordinary rec’d posts. > > I have Posterior Tibial Tendon Disorder (PTTD) in both ankles. **Is this painful failure of the tendon (collagen) that holds up the arch of the foot related to my aortic valve problem? Hmmm…** > > Wendy An interesting thought. After my husband’s surgery, part of the post op follow-up was a genetic workup (asking that pesky question “why”) His aortopathy was manifestly a congenital situation…something shared by many others in the Big Aorta Club at the University Hospital in Denver…and asking such pertinent questions is obviously important with a patient who has offspring/close relatives alive, in addition to furthering understanding of the condition. During the chit chat around a possible underlying collagen disorder I happened to mention a couple of ligament/tendon strains husband had experienced recently…and that he’d suffered a ruptured Achilles tendon back in 1984 during an easy game of squash. We/he’d always put it off as one of those things…which, as a “one off” it is. However, when the doctor heard this her eyes lit up and that phrase we use a lot in out house was heard…“Now _ **that’s** _ interesting…” It seems that husband was the third person in a relatively short time to have mentioned something similar (not Achilles, but other tendon ruptures under atypical circumstances) Of course, it may well _still_ be just one of those things or a funky coincidence rather than a pattern…but you never know, right? And never _will_ know if someone doesn’t ask the “why” or “what if” questions. ---
**Author:** ![Leap1](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/leap1/32/72176_2.png) [@Leap1](https://discussion.fool.com/u/Leap1)\ **Post date:** [September 26, 2024, 1:10am UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/16 "2024-09-26T01:10:07Z")
It can be all of the above. It is what it is ---
**Author:** ![WendyBG](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/wendybg/32/67464_2.png) [@WendyBG](https://discussion.fool.com/u/WendyBG)\ **Post date:** [September 26, 2024, 1:45am UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/17 "2024-09-26T01:45:14Z")
> [@Leap1](#): > > Hypercalcemia, or high calcium levels, can lead to heart valve problems, including aortic valve sclerosis and aortic valve stenosis. @Leap1 all my electrolytes, including calcium, have been measured and are normal. Wendy ---
**Author:** ![Leap1](https://sea2.discourse-cdn.com/motleyfoolfree/user_avatar/discussion.fool.com/leap1/32/72176_2.png) [@Leap1](https://discussion.fool.com/u/Leap1)\ **Post date:** [September 26, 2024, 10:20am UTC](https://discussion.fool.com/t/totally-ot-the-mystery-of-lp-a/109002/18 "2024-09-26T10:20:03Z")
Mine are as well but calcium lines my arteries in a very small thin layer. The blood stream is different from the cellular activity. We do not know. If any of us got it right we still would not know. adding Quick look up Yes, aortic valve calcification can occur even if calcium blood levels are not high: - Aortic valve sclerosis A condition that causes mild calcium buildup and thickening of the aortic valve. It’s common in older adults and usually doesn’t cause serious heart problems. However, it can lead to aortic valve stenosis. - Calcific aortic valve disease A slowly progressive disease that ranges from aortic sclerosis to aortic stenosis. Aortic sclerosis is mild valve thickening without obstruction of blood flow, while aortic stenosis is severe calcification that impairs leaflet motion and obstructs blood flow. - Aortic stenosis A condition that can be caused by atherosclerosis, which is a buildup of calcium on the aortic valve over time. Symptoms include an irregular heartbeat, chest pain, shortness of breath, and fatigue. - Risk factors Some risk factors for aortic valve calcification include hyperparathyroidism, mitral annular calcification, and calcium supplementation.