--- title: "Vascular Health" date: "2026-09-08" modified: "2026-09-08" medically_reviewed: "2026-09-08" canonical_url: "https://www.threeriversmedicine.com/what-we-do/vascular-health" # Service / MedicalProcedure schema_type: "MedicalProcedure" procedure_type: "NoninvasiveProcedure" service_name: "Vascular Health" service_description: "Vascular health screening at Three Rivers Concierge Medicine: coronary calcium scoring and advanced lipid panels \u2014 including Lp(a) and ApoB \u2014 with a personalized prevention plan from Dr. Shoemaker." # Provider organization: "Three Rivers Concierge Medicine" organization_type: "MedicalBusiness" service_area: "Greater St. Louis, Missouri" medical_specialty: "Primary Care, Endocrinology" practice_model: "Direct Primary Care - Membership Based" # FAQ Structured Data faq: - question: "What is Lp(a), and why do I only need to test it once?" answer: "Lipoprotein(a) is largely determined by your genes, so levels stay stable across your life. One test tells you whether it\u2019s a factor for you \u2014 and if it\u2019s elevated, it informs prevention decisions permanently. If you\u2019ve never been tested, it\u2019s one of the highest-value single labs in preventive medicine." - question: "What does a coronary calcium score tell me?" answer: "It measures calcified plaque in your coronary arteries. A score of zero is powerful reassurance; a higher score means risk is real and prevention should be more aggressive. Either way, you and Dr. Shoemaker are deciding from evidence, not averages." - question: "Who should consider vascular screening?" answer: "Most adults benefit from knowing their numbers \u2014 and it\u2019s especially valuable for men over 40, anyone with a family history of heart disease or stroke, and patients weighing whether a statin is right for them." - question: "Is vascular screening included in my membership?" answer: "Your membership covers the visit time and the clinical expertise to interpret results in context. Advanced lipid panels and calcium scoring may involve separate lab or imaging fees depending on your insurance coverage \u2014 Dr. Shoemaker will recommend what\u2019s appropriate for your risk profile. We test purposefully, not indiscriminately." - question: "Do I need a referral for a calcium score?" answer: "No referral hassle \u2014 Dr. Shoemaker orders the scan at a local imaging center and reviews the results with you directly." # Patient Reviews aggregate_rating: "4.6" review_count: 10 --- # Vascular Health ## Table of Contents * [Vascular Health](https://www.threeriversmedicine.com/what-we-do/vascular-health#vascular-health) * [The numbers standard tests miss](https://www.threeriversmedicine.com/what-we-do/vascular-health#the-numbers-standard-tests-miss) * [Lp(a)](https://www.threeriversmedicine.com/what-we-do/vascular-health#lp-a) * [ApoB](https://www.threeriversmedicine.com/what-we-do/vascular-health#apob) * [CAC](https://www.threeriversmedicine.com/what-we-do/vascular-health#cac) * [One number that changes the plan](https://www.threeriversmedicine.com/what-we-do/vascular-health#one-number-that-changes-the-plan) * [Your first 30 days](https://www.threeriversmedicine.com/what-we-do/vascular-health#your-first-30-days) * [Unhurried visit](https://www.threeriversmedicine.com/what-we-do/vascular-health#unhurried-visit) * [Calcium scan](https://www.threeriversmedicine.com/what-we-do/vascular-health#calcium-scan) * [The conversation](https://www.threeriversmedicine.com/what-we-do/vascular-health#the-conversation) * [Your plan](https://www.threeriversmedicine.com/what-we-do/vascular-health#your-plan) * [From Results to a Plan](https://www.threeriversmedicine.com/what-we-do/vascular-health#from-results-to-a-plan) * [Know your numbers. Understand your risk.](https://www.threeriversmedicine.com/what-we-do/vascular-health#know-your-numbers-understand-your-risk) * [What is Lp(a), and why do I only need to test it once?](https://www.threeriversmedicine.com/what-we-do/vascular-health#what-is-lp-a-and-why-do-i-only-need-to-test-it-once) * [What does a coronary calcium score tell me?](https://www.threeriversmedicine.com/what-we-do/vascular-health#what-does-a-coronary-calcium-score-tell-me) * [Who should consider vascular screening?](https://www.threeriversmedicine.com/what-we-do/vascular-health#who-should-consider-vascular-screening) * [Is vascular screening included in my membership?](https://www.threeriversmedicine.com/what-we-do/vascular-health#is-vascular-screening-included-in-my-membership) * [Do I need a referral for a calcium score?](https://www.threeriversmedicine.com/what-we-do/vascular-health#do-i-need-a-referral-for-a-calcium-score) * [Our Other Services](https://www.threeriversmedicine.com/what-we-do/vascular-health#our-other-services) * [Physician-led cardiovascular risk screening — coronary calcium scoring and advanced lipid testing, interpreted in the context of your whole health.](https://www.threeriversmedicine.com/what-we-do/vascular-health#physician-led-cardiovascular-risk-screening-coronary-calcium-scoring-and-advanced-lipid-testing-interpreted-in-the-context-of-your-whole-health) --- ![Doctor and smiling patient form a heart with hands.](https://www.threeriversmedicine.com/sites/default/files/media/images/2025-01/iStock-1766603296.jpg) Calcium scoring and advanced lipid panels to reveal your true heart risk ## Vascular Health ![Elderly couple smiling, embracing outdoors in front of a rocky landscape.](https://www.threeriversmedicine.com/sites/default/files/media/images/2026-01/iStock-1471486019_0.jpg) MO ![Doctor measuring patient's blood pressure.](https://www.threeriversmedicine.com/sites/default/files/media/images/2025-01/iStock-175264754.jpg) Heart disease is still the leading cause of death for both men and women — and the standard cholesterol panel misses some of the strongest predictors of risk. At Three Rivers, vascular health screening goes deeper: advanced lipid markers, coronary calcium scoring, and a physician who interprets the results in the context of your life, your family history, and your goals. Beyond Cholesterol ## The numbers standard tests miss A routine lipid panel reports four numbers. These three tell the rest of the story — and Dr. Shoemaker orders all of them. ## Lp(a) Lipoprotein(a) An inherited particle that raises risk independently of LDL. One in five people carries elevated Lp(a) — most have never been tested. Tested once in a lifetime ## ApoB Apolipoprotein B A direct count of the particles that deposit cholesterol in artery walls. Two people with the same LDL can carry very different risk — ApoB tells them apart. Every advanced panel ## CAC Coronary Artery Calcium A quick, low-dose CT scan that measures the plaque already in your coronary arteries — a direct look, not a statistical estimate. One scan, ordered for you Coronary Calcium Scoring ## One number that changes the plan Your calcium score puts your heart risk on a scale — and every point on it has a next step. 01–99100–399400+ **Powerful reassurance**Confidence in the plan you’re already on. **Plaque is present**The best time to act — early. **Real risk, real plan**Prevention gets specific and personal. **Aggressive prevention**Every tool, starting now. Whatever your score, you’ll go through it with Dr. Shoemaker — unhurried, in plain language.[Know Your Heart Risk](/get-started) The Experience ## Your first 30 days ## Unhurried visit Your story, your family history, and advanced labs — including Lp(a) and ApoB. ## Calcium scan We order it at a local imaging center. No referral maze, no waiting on paperwork. ## The conversation Your results, explained in plain language — with time for every question. ## Your plan Prevention built on your biology — and a doctor you can reach as it unfolds. ## From Results to a Plan Numbers only matter if they change what you do next. That’s the concierge difference: unhurried time with your physician to work through what your results actually mean. - If guidelines suggest a statin, you’ll understand your case — the factors that raise your risk, the ones that lower it, and where the real decision point lies. - If a statin isn’t right for you, alternatives like PCSK9 inhibitors (such as Repatha) may be worth discussing. - If your numbers are reassuring, you’ll know that too — and when to check again. No cookie-cutter protocols. A prevention plan built on your biology, and a doctor you can reach when questions come up. Vascular Health at Three Rivers ## Know your numbers. Understand your risk. Advanced lipid testing and calcium scoring, interpreted by a physician who knows your whole picture. [Get Started](/get-started) [Explore All Screenings](/what-we-do/advanced-testing-screenings) ### What is Lp(a), and why do I only need to test it once? Lipoprotein(a) is largely determined by your genes, so levels stay stable across your life. One test tells you whether it’s a factor for you — and if it’s elevated, it informs prevention decisions permanently. If you’ve never been tested, it’s one of the highest-value single labs in preventive medicine. ### What does a coronary calcium score tell me? It measures calcified plaque in your coronary arteries. A score of zero is powerful reassurance; a higher score means risk is real and prevention should be more aggressive. Either way, you and Dr. Shoemaker are deciding from evidence, not averages. ### Who should consider vascular screening? Most adults benefit from knowing their numbers — and it’s especially valuable for men over 40, anyone with a family history of heart disease or stroke, and patients weighing whether a statin is right for them. ### Is vascular screening included in my membership? Your membership covers the visit time and the clinical expertise to interpret results in context. Advanced lipid panels and calcium scoring may involve separate lab or imaging fees depending on your insurance coverage — Dr. Shoemaker will recommend what’s appropriate for your risk profile. We test purposefully, not indiscriminately. ### Do I need a referral for a calcium score? No referral hassle — Dr. Shoemaker orders the scan at a local imaging center and reviews the results with you directly. ## Our Other Services ## Physician-led cardiovascular risk screening — coronary calcium scoring and advanced lipid testing, interpreted in the context of your whole health. Vascular health screening at Three Rivers Concierge Medicine: coronary calcium scoring and advanced lipid panels — including Lp(a) and ApoB — with a personalized prevention plan from Dr. Shoemaker.