Patient's Query
Hello doctor,
I have the results of a CT coronary artery scan and would like them analyzed for blockages. The report indicates a 100 percent occlusion in the RCA and some blockage in the LAD.
Please advise.
Hello,
Welcome to icliniq.com.
I have carefully reviewed your coronary angiography CT images (attachments removed to protect the patient’s identity). There is extensive calcification within the RCA (right coronary artery), which appears to cause significant narrowing. Additionally, calcified lesions are present in the proximal portion of the LAD (left anterior descending artery), with some scattered calcification in the LCx (left circumflex artery).
Given these findings, along with the presence of coronary risk factors, the best next step would be to proceed with a coronary angiography. This examination will provide clarity on the current coronary lesions and guide the ongoing management strategy. Please discuss this diagnostic approach with your attending cardiologist.
I hope this information has been helpful.
Patient's Query
Hello doctor,
Thank you for the reply.
Do you think the RCA is less than 100 percent occluded? Where can I see the aorta in these images? Could you elaborate on where the narrowing occurs and the position of the aorta?
Hello,
Welcome back to icliniq.com.
Regarding your RCA, it is difficult to determine from the uploaded images whether it is fully occluded or severely narrowed (90 to 99 percent), as some contrast appears even beyond the extensive proximal calcified lesions. Equally concerning is your LAD, as it appears to have a long calcified lesion in the proximal portion. Just after the third diagonal (D3), there seems to be a significant narrowing (99 percent) that is nearly occlusive. This is serious and needs confirmation with coronary angiography.
Please note that while a coronary CT angiogram provides useful insights, it has limitations in precisely defining coronary lesions due to potential artifacts (from factors like heart rate, body weight, lung position, calcium deposits, etc.). Coronary angiography remains the gold standard for confirming these findings. The combination of extensive calcification and observed narrowing raises concerns about significant coronary lesions, though some findings may be due to artifacts. However, the extensive calcifications appear quite real.
I would be glad to review your angiography reports once completed.
Kind regards.
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