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The amount of plaque in your coronary arteries can be estimated by looking directly at your coronary arteries with a cardiac CT and calculating your CAC score. This also means that if you have a CAC score of 0, you have no calcified plaque in your coronary arteries. 2 JACC: Cardiovascular Imaging May 2015, 8 (5) 579-596;
Patients undergoing coronary angiography between January 2014 and December 2015 were included in the analysis. Eligible patients had at least one inpatient coronaryangiogram for suspected coronary artery disease between January 2014 and December 2015.
Ct coronaryangiogram showed normal coronary arteries. Smith note: I think CT coronaryangiogram is reasonable with the elevated troponins and symptoms. He was given aspirin and heparin and transferred to the local cardiac center for further evaluation. He was diagnosed with mild AKI which resolved.
Cardiology felt her chest pain to be, most likely, the result of coronary supply-demand mismatch in the context of HCM endothelial remodeling (i.e. Type II MI), however decided to pursue coronaryangiogram out of an abundance of caution. A mid-LAD culprit lesion was identified and stented. References Naidu, S. Tower-Rader, A.
The diagnostic coronaryangiogram identified only minimal coronary artery disease, but there was a severely calcified, ‘immobile’ aortic valve. Aortic angiogram did not reveal aortic dissection. 2015 Oct; 66(4):355-362. The patient was brought directly to the cardiac catheterization lab for PCI, bypassing the ED.
Case Continued The patient was discharged from the hospital with a plan for a scheduled coronaryangiogram to assess the coronary arteries and the possibility of aortic valve replacement. The vast majority of ischemia from supply demand mismatch is diffuse ST depression, with ST Elevation in aVR.
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