Brief Answer:
Normal CT coronary angiogram.

Detailed Answer:
Hello again,
Have seen the reports.
Your CT coronary angiogram is normal and you need not to worry.

Calcium is a chemical element that is essential for living organisms.Most of the calcium within the human body is found in teeth and bone. A small amount, about one percent of total body calcium, is dissolved in the blood.When we age, calcium deposits can be found in many parts of our bodies. Calcification of the walls of the arteries is common in people aged 65 and older. Some degree calcification of arteries and internal organs can be regarded as a normal part of aging.
Although calcification of the coronary arteries can be regarded as an aging phenomenon, extensive calcification appears to reflect more severe atherosclerosis, higher risk of heart attack, and worse prognosis.
Coronary calcium is part of the development of atherosclerosis; it occurs exclusively in atherosclerotic arteries and is absent in the normal vessel wall.

Based on a number of studies, the following definitions are used to relate the coronary artery calcium score to the extent of atherosclerotic coronary artery disease:

Coronary calcium score 0: No identifiable plaque. Risk of coronary artery disease very low (<5%)
Coronary calcium score 1-10: Mild identifiable plaque. Risk of coronary artery disease low (<10%)
Coronary calcium score 11-100: Definite, at least mild atherosclerotic plaque. Mild or minimal coronary narrowings likely.
Coronary calcium score 101-400: Definite, at least moderate atherosclerotic plaque. Mild coronary artery disease highly likely. Significant narrowings possible
Coronary calcium score > 400: Extensive atherosclerotic plaque. High likelihood of at least one significant coronary narrowing.

Your score is 3 which means that clinically there is no calcium in your coronaries and chances of having cardiac problem is less then 10%.

Other things reflected are you have a right doninant heart(90% of people have) in which posterior descending artery is a branch of right coronary artery.

No stenosis or occlusion is seen in arteries this means that all vessels are ok.

So final verdict is that your CT angiobis perfectly normal and as per the results chances of you having Coronary disease is extremely low.

In case you have further questions feel free to ask.
For uploading further images please contact customer care.

Regards.


Brief Answer:
Follow up.

Detailed Answer:
Hello,

My email id is YYYY@YYYY
Deposition of calcium in coronary arteties in a natural phenomenon which starts after an age of 10 years usually.Practically its impossible for a young adult to have zero score.
Please mail the images for further advice.
Tortous is the path followed by coronary artery.In some person it has straight path way in other it may be tortous.Its natural and have no clinical sinificance in your case.
Regards.

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Brief Answer:
Follow up.

Detailed Answer:
Hello again dear,
Have gone through all attachements.
There is no sign of even minor plaque formation in any of the coronaries.
Ct coronary angio is around 60-70% sensitive in ruling out coronary artery disease.
So as per the images attached by you your coronaries are perfectly normal.
Mild artifact can be there while doing any investigation.Our basic purpose during this test was to rule out blockage of coronaries.

However the gold standard test is either an angiogram(99% sensitive) or stress thallium almost 98% sensitive.However as you are asymptomatic and young none of these tests are required.

Thanks.

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Brief Answer:
Follow up advice

Detailed Answer:
Hi there,
You have not mentioned your chief complaints in initial question.

As palpitation and dizziness is your primary problem i would suggest you to go for the following tests which are usually done in patients suffering from palpitation and dizziness.





24 hour holter monitoring-A small device would be attached to your body for 24hours.It will keep a record of your heart beat (both rate and rhythm) for a period of 24 hours.You can also note the time during which you feel palpitations and the rythm at that time could be seen on computer monitor during interpretation of the test.It is the basic and most important test for you.



7 days loop recorder- In case faulty heart beats are not recorded in holter ,A device called loop recorder would be attached to your body for 7days and it will keep a record of your heart beats for 7 days!


Carotid doppler- Carotid artery supplies blood to brain.Blockage in carotid artery can be responsible for dizziness.
Tread mill test -some times the faulty heart beats are precipitated only when the heart is under stress,Tread mill test is designed for that,You will be made to run on a tread mill under monitored condition.Any arrythmia precipitated can be observed on computer recording.



Apart from this Thyroid function test should be done.A increased in level of thyroid hormone can cause palpitations.Basic investigations are to be done before reaching a diagnosis.

CT angiogram is primarily meant to see if there is any blockage in coronary artery or not.However it has no significant relevance in examining a patient whose chief complaints are palpitation and dizziness.

HUTT test-During the test, you lie on a table that is slowly tilted upward. The test measures how your blood pressure and heart rate respond to the force of gravity.


If possible kindly mention all your symptoms and medications you are on.
Reason for which CT angio has been done by your cardiologist.
Duration of palpitations?
Any observed relieving or precipitating factor?
How often do you feel dizzy?
Is dizziness related to palpitations?
Is it verigo(Rotatory in nature)?
Thanks

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Brief Answer:
Its not cardiac.

Detailed Answer:
Hello dear.
In case all these investigations are normal then i don't think palpitations or dizziness are related to cardiac system.
Palpitations are also caused due to anxiety.
Panic attack symptoms often mimic cardiac symptoms.Dizziness and Palpitation can be caused in panic attacks also.
I would suggest to go for a pyschological consultation.
Dizziness can sometimes be caused due to chronic conditions related to inner ear like labyrinthitis,Menieres disease.A thorough check up by otolaryngologist should also be done.

Take home message-
Its not cardiac.
Regards.

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Brief Answer:
Follow up.

Detailed Answer:
Hello again,
Don't worry its really good to answer your queries.
Ideally 2 d echo ,stress test ,lipid profile,Carotid doppler should be done once in a year after age of 25.

Thanks.

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Brief Answer:
Follow up.

Detailed Answer:
Hi again,
If cost is not a problem then yes going by protocols mentioned in standard books these tests should be done once in a year by every person more then 25 years of age.
However once in 2 years can also be followed by you as even your CT coronary angio is also normal.

Regards.

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