Thanks, Charlene, for sharing your experience. It is very difficult to comment on your case. There is a confusion of terminology. An ECG sonogram is an ultrasound technique that provides information on the structure and function of the heart in moving pictures, whereas the EKG is a recording of the electrical signals of the heart. So, there is no EKG sonogram. But anyway, there is no reason why either of those "did not work" other than the operator couldn't get it right. While it is not untypical for women to have had silent heart attacks that remained unnoticed, it is very unlikely (though not entirely impossible) with a CAC score zero. After all, there is MINOCA (myocardial infarction with no obstruction of coronary arteries), but your cardiologist is in the best position to advise you.