Coronary CT Angiography Results: What They Mean for Heart Health

Q: Coronary CT Angiography Results: What They Mean for Heart Health

Hello： The examination results indicate moderate to severe stenosis of the coronary arteries. <br>It is recommended to initiate at least medication therapy. <br>If there are frequent symptoms of chest tightness or shortness of breath, consider undergoing catheterization treatment

Coronary CT Angiography

Dear Doctor,
My father is 75 years old and today he underwent some examinations.
The report is as follows:
Coronary artery plain scan shows calcification in the left anterior descending artery, diagonal branch, and right coronary artery, with calcification scores of 22.06, 30.41, and 25.12 respectively, totaling 77.59.

Coronary artery enhanced scan reveals a right dominant coronary system.
The left main coronary artery is well visualized with no significant plaque stenosis.
A localized mixed plaque is observed in the proximal segment of the left anterior descending artery, accompanied by moderate stenosis of about 55%.
The mid-segment of the left circumflex artery is well visualized with no plaques or stenosis.
The distal segment is also visualized, and the obtuse marginal branch is well visualized.
The proximal segment of the right coronary artery shows a localized calcified plaque with obscured lumen, while the remaining segments are well visualized with no plaques or stenosis.

Impressions:
1.
Calcification is observed in the left anterior descending artery, diagonal branch, and right coronary artery, with a total calcification score of 77.59.

2.
The coronary arteries exhibit a right dominant pattern.

3.
A localized mixed plaque is noted in the proximal segment of the left anterior descending artery with severe stenosis.

4.
A localized calcified plaque is seen in the proximal segment of the right coronary artery with obscured lumen.

5.
A localized calcified plaque is noted in the diagonal branch of the left coronary artery with severe stenosis.

Could you please advise if my father's condition is serious? Is it coronary artery disease? What treatment options should be considered? Our family is very concerned due to his age and the fear of a myocardial infarction.
Thank you, Doctor!

Mei Hao, 70~79 year old female. Ask Date: 2023/03/15

Dr. Huang Yinghe reply Cardiology

Hello: The examination results indicate moderate to severe stenosis of the coronary arteries.
It is recommended to initiate at least medication therapy.
If there are frequent symptoms of chest tightness or shortness of breath, consider undergoing catheterization treatment.
Please consult your father's physician for further treatment options.

Reply Date: 2023/03/15

More Info

Understanding the results of a coronary CT angiography (CTA) is crucial for assessing heart health, especially in older patients like your father, who is 75 years old. Based on the report you provided, there are several important findings that we need to analyze.

1. Coronary Artery Calcium Scores: The report indicates calcium scores for the left anterior descending artery (LAD), diagonal branch, and right coronary artery (RCA), with a total calcium score of 77.59. Calcium scoring is a method used to evaluate the presence of coronary artery disease (CAD). A higher calcium score typically indicates a greater burden of atherosclerotic plaque, which can lead to coronary artery narrowing and increase the risk of cardiovascular events. In general, a score above 100 is considered significant, while scores above 400 indicate a high risk for heart disease. Your father's score of 77.59 suggests that there is some degree of calcification, which is a marker of potential coronary artery disease.

2. Presence of Plaques and Stenosis: The report mentions that the left anterior descending artery shows a mixed plaque with moderate stenosis of 55%. This is significant because a stenosis of 50% or more can lead to reduced blood flow to the heart muscle, especially during physical exertion. The presence of mixed plaques indicates that there may be both calcified and non-calcified components, which can be more unstable and prone to rupture, potentially leading to acute coronary events such as myocardial infarction (heart attack).

3. Right Coronary Artery Findings: The right coronary artery shows localized calcified plaques with unclear visualization due to obscured lumen. This could indicate that there is some degree of blockage, but the exact severity cannot be determined from this report.
4. Overall Impression: The findings suggest that your father has coronary artery disease, particularly with the significant stenosis in the left anterior descending artery. The presence of calcified plaques in the right coronary artery also raises concern for potential ischemic events.

Recommendations for Management
Given your father's age and the findings from the CTA, it is essential to take the following steps:
1. Consultation with a Cardiologist: It is crucial to discuss these findings with a cardiologist who can provide a comprehensive evaluation. They may recommend further testing, such as a stress test or a coronary angiogram, to assess the severity of the blockages and determine the best course of action.

2. Lifestyle Modifications: Encourage your father to adopt heart-healthy lifestyle changes. This includes a balanced diet low in saturated fats and cholesterol, regular physical activity (as tolerated), smoking cessation if applicable, and maintaining a healthy weight.

3. Medication Management: Depending on the cardiologist's assessment, medications such as statins (to lower cholesterol), antiplatelet agents (like aspirin), or beta-blockers may be prescribed to manage symptoms and reduce the risk of heart attacks.

4. Monitoring Symptoms: Keep a close watch on any symptoms such as chest pain, shortness of breath, or fatigue. If these symptoms worsen or new symptoms arise, seek immediate medical attention.

5. Regular Follow-ups: Regular follow-up appointments with the cardiologist are essential to monitor your father's heart health and adjust treatment as necessary.

In conclusion, your father's condition does indicate coronary artery disease, and while it is concerning, proactive management can significantly reduce the risk of serious events like myocardial infarction. Open communication with healthcare providers and adherence to recommended lifestyle changes and treatments will be key in managing his heart health effectively.

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