Hello, my name is Doctor Saleem Ur Rehman and I will answer your question. Welcome to HCM. First I must reassure you that even though your tests may feel ominous to you, the diverse array of procedures that your doctor will have to choose from, gives him the power to minimize the possibility of any Hard Cardiac Event. In simple words, dont worry! Technology has advanced enough to allow your doctor to take care of you .. Your nuclear stress test has revealed decreased blood flow to part of your heart, and that coupled with the high calcium score predicts the probability of an impending Heart Attack. Basically part of your blood vessel supplying blood to your heart has developed an atheromatous plaque over time. Atheromatous plaques are formed by deposition of fats in the vessel walls and are dangerous because they can rupture any time and cause blockage of the vessel due to coagulation of blood. When you meet your doctor, he will most probably order an angiography to look directly at your heart vessels. It will tell him about the health of your cardiac vessels and the exact amount of blockage. Depending on the degree of blockage and extent of vessels involved, he may either order a coronary intervention (to install a stent in the affected vessel, thus increasing the blood flow and avoiding sudden arterial blockage) and put you on medication to limit the atheromatous plaque, or medications only. He will also ask you to change your lifestyle and avoid high calorie diet with more fat content. That will help in preventing increase in size of the existing plaque and formation of more plaques.. If you have any further querries, you can contact me on my email address. I will be happy to answer them in detail. Wishing you good luck. May you have a healthy life soon.