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43 years old with normal cholesterol. CT coronary angiogram done. Anything serious?

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Practicing since : 1966
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Hi ,
Just hoping you can give me some info regarding a ct coronary angiogram I had the other day.
It gave me a calcium score of 6.4 in my LAD. I'm 43 years old with normal cholesterol . Is this serious.
Posted Tue, 5 Mar 2013 in General Health
Answered by Dr. Anantharamakrishnan 1 hour later
Hi friend,
Welcome to Health Care Magic

This (less than 10 %) is the lowest one can get!
This is the minimal calcification / There is nothing serious / With normal cholesterol, problems, if any, depend on other risk factors - heredity, Diabetes, Obesity, Smoking and so on.

Take care
Wishing speedy recovery
God bless
Good luck
Above answer was peer-reviewed by
Follow-up: 43 years old with normal cholesterol. CT coronary angiogram done. Anything serious? 2 days later
Hi Doctor,
I'm going to give you the full report of the ct angiogram as my gp didn't really understand the results and I don't either.
Calcified plaque in the LAD and right coronary systems yielding a score of 6.4.
The angiogram quality is fair with good motion suppression though contrast to noise ratio is suboptimal particularly for peripheral sections.
Right coronary dominant with no significant anomaly.
No detectable non calcified coronary plaque though sensitivity is suboptimal due to noise. No coronary stenosis.
The aortic root is normal in calibre and appearance with no evidence for dissection.
No evidence of pericardial disease.
A low absolute though moderately high relative coronary atherosclerotic plaque burden with a score of 6.4.
No coronary stenosis within proximal or mid segments, most distal portions of the distal segments are suboptimally displayed due to unavoidable image noise.

Can you tell me what this means, my doctor isn't concerned.
Answered by Dr. Anantharamakrishnan 3 hours later

CT is Computerised Tomogram (X-ray)
     The artery supplying blood to the heart is called coronary artery. The LEFT MAIN immediately divides into Left Anterior descending (LAD) - going down in the groove between the ventricles / and Left Circumflex – goes round leftward, in the groove between atrium (upper chamber) and the ventricle (lower chamber).
The Right Coronary Artery (RCA) goes around rightward in the atrio-ventricular groove.
     Artefacts due to movement of heart and chest will reduce the picture quality. Here, the picture is reasonable / a bit less in the outer portions.
     If RCA turns and continues in the inter-ventricular groove behind the heart, it is called dominant.
     The big blood vessel coming out of left side lower chamber (ventricle) to supply the entire body with oxygenated blood is called Aorta. It is normal in size. There is no tear.
     No block of blood vessels found / the farthest portions of the vessels could not be seen well because of technical problems.
     No problem in the outer membrane lining of the heart.

     The quantity of calcium accumulated in the blood vessels is detected by the X-ray. It has direct correlation with Coronary Artery Disease. Its amount is expressed as Calcium Scoring. Less than 1 is no calcification – unlikely to have disease / 1 to 10 is minimal / 11 to 100 is small / 101 to 400 is moderate / More than 400 is large – highly likely to have disease.
     The narrowing of lumen from thickening of the wall is called plaque / the volume is called plaque burden. It is a better indicator than calcium. The degree and site of narrowing (even nature of the plaque) could be detected and expressed. If the lumen/diameter of the blood vessels are normal - there is no detectable narrowing - no disease! Only 70% narrowing is significant for most vessels; 50% for LAD; 40% for left main artery
           In case of doubt, Coronary angiography is the gold standard.

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Follow-up: 43 years old with normal cholesterol. CT coronary angiogram done. Anything serious? 24 hours later
So I've got nothing to worry about?
Answered by Dr. Anantharamakrishnan 1 hour later

All well.
No cause for concern.
But, why did you do it at all - is the question / discuss with your internist for further assessment and assistance.

God bless you
Above answer was peer-reviewed by
Follow-up: 43 years old with normal cholesterol. CT coronary angiogram done. Anything serious? 4 hours later
I suffer from anxiety badly, maybe I've got to sort that out, thanks very much for your input doc,
Answered by Dr. Anantharamakrishnan 15 hours later

Anxiety, for many, is often an integral part of today’s life!
It is a bit difficult to escape? – not really...
The situations are several and varied – our reactions too differ.

We should not allow extraneous circumstances to affect us.
If we could not control ourselves, others will take up the job (of control)!

The very fact that you acknowledge your anxiety is the first and major step towards improvement.
You need to concentrate on your work / you need to develop diversions too - a hobby like reading / walking – you see people and places / going to park or beach / yoga, bio-feed back, relaxation exercises and so on.
Develop good rapport with family – say mother and/or spouse; and well meaning friends
Religion helps many.
Of course, Psychiatric consultation and counselling will be the first step.

The chances of your returning to normalcy are great indeed – in spite of us, if not because us!
Sorry for the long sermon!

God bless you
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