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What Does My CT Coronary Angiography Result Report Indicate?

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Posted on Tue, 5 Jan 2016
Question: I get chest pains intermittently. I have undergone a CT Coronary Angiography. Result show long mild diffuse atheromatous concentric wall thickening in mid RCA with 42% luminal narrowing CTA wise.... there is a similar finding in of 36% luminal narrowing in distal LAD ... Calcium score is Zero. Do I need stent implant or any invasive procedure now or it can be managed with medication?
doctor
Answered by Dr. Anantharamakrishnan (4 hours later)
Brief Answer:
Medical Management ONLY

Detailed Answer:
Hi friend
Welcome to Health Care Magic

You need only Medical management.
You do NOT need any intervention – angioplasty and stent are done only when the narrowing is 70 % or more.

     Only very rarely, with less severe obstruction, if the symptoms are severe – when coronary flow reserve is estimated by angio for decision making.
     Your pain may not be from the heart! A TMT (Treadmill Exercise ECG) with thallium isotope may clarify the issue - it is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle.

Follow up with your doctor

Good luck
God bless you
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan (3 hours later)
Thank you for your reassuring reply. I am having this pain for over 10 years now. I had this stress thallium test done about 5 years ago and no abnormalities were detected in that. I am hypertensive and take Metpure XL (25) - 1 tab sheet breakfast, Telma 40 - 1 tab twice daily ( after breakfast+ dinner), Asomex 2.5 mg - 1 tab after dinner & Crevast 10 - 1 tab after dinner. Is there any need to add any medication? Can i just ignore the chest pain as it occurs now? after
doctor
Answered by Dr. Anantharamakrishnan (3 hours later)
Brief Answer:
No need for further test or medicine

Detailed Answer:
Hi

The very long duration itself suggests that it is not serious..
A negative thallium excludes any significant Coronary Artery Disease
The medicines for Blood pressure and cholesterol are appropriate and state of the art
You are in good hands

No need for further investigation at present / Go for routine treadmill exercise ECG every year or two
No need for further medicines
Ignore the problem and enjoy life

Regards
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan (2 days later)
Thank you for the kind reassurance. After this CT angiogram report, can i get on with my normal activities & foods? Or do i need to cut down on business travel &/or food? I am obese at 105 kg height 6 ft. I have started doing workouts off late. Any other lifestyle modification you suggest based on this CT angiogram report Doctor?s
doctor
Answered by Dr. Anantharamakrishnan (36 minutes later)
Brief Answer:
Details below

Detailed Answer:
Hi

Yes – get on with your NORMAL activities
No need to cut down on business travel

FOOD –
     Healthy food is a must. Avoid saturated fats – coconut oil, palm oil, butter, ghee, full cream milk...Avoid junk foods in particular – French fries have palm oil / Pizza has cheese / XXXXXXX sweets are made in ghee.../ Change to Poly-un-saturated oil – like sun flower oil. / Include Mono-un-saturated oil – Olive oil.

EXERCISE
     Do regular EXERCISE – say walking or jogging - 30 minutes a day / at least 5 days in a week. Isometric exercise (like bull worker) is bad.

WEIGHT
     Your BMI is 32.4 // Normal weight = 18.5–24.9 / Overweight = 25–29.9 / Obesity = BMI of 30 or greater
     Keep your weight to normal / even a little less. Weight is like bank account - The amount in your account comes down when you withdraw more (physical work) and you deposit less (eat less). If the weight is picking up, it only means – the exercise is not enough / the food is more / or both....
See a good dietician - you have to reduce the quantity of your food and change the quality too.

OTHER LIFE STYLE –
Quit smoking, if you are a smoker
     Be ‘saathvic’ – avoid anger and competitive personality

Keep following up with your doctor regularly

Regards
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj
doctor
Answered by
Dr.
Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4505 Questions

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What Does My CT Coronary Angiography Result Report Indicate?

Brief Answer: Medical Management ONLY Detailed Answer: Hi friend Welcome to Health Care Magic You need only Medical management. You do NOT need any intervention – angioplasty and stent are done only when the narrowing is 70 % or more. Only very rarely, with less severe obstruction, if the symptoms are severe – when coronary flow reserve is estimated by angio for decision making. Your pain may not be from the heart! A TMT (Treadmill Exercise ECG) with thallium isotope may clarify the issue - it is the ideal non-invasive way to evaluate ischemia / to assess the PHYSIOLOGY (function) – to see whether the blood arriving at the heart muscle. Follow up with your doctor Good luck God bless you