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How Accurate Are The Results Of A CT Scan Test?
Question: I have recently done a CT of the heart with attention to the coronary arteries. The test was performed by a Siemens HeartView CT. The total number of coronary calcifications has shown as 1653.0. The report also suggests that a calcium score of 401 and above is classified as Significant Calcification.
Here are my questions:
1) Could this be an error of the machine? Could this just be one bogus number? (Given the fact that 401 is already considered significant)
2) Is it even possible for someone like me (no previous or family history of heart disease, no presence of high cholestorel) to have such high number of coronary calcifications?
3) I have appointment with the ordering physician next week, what should I ask for? Maybe repeating the test?
4) What are the possible next steps that my PCP might offer and how should I react to them? (e.g. another test that is more invasive in nature, an invasive type of treatment)
5) How is such a high score of calcifications usually being treated?
Here are my questions:
1) Could this be an error of the machine? Could this just be one bogus number? (Given the fact that 401 is already considered significant)
2) Is it even possible for someone like me (no previous or family history of heart disease, no presence of high cholestorel) to have such high number of coronary calcifications?
3) I have appointment with the ordering physician next week, what should I ask for? Maybe repeating the test?
4) What are the possible next steps that my PCP might offer and how should I react to them? (e.g. another test that is more invasive in nature, an invasive type of treatment)
5) How is such a high score of calcifications usually being treated?
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain that deciding to perform a coronary CT, the reason is to predict approximate relative risk of having a heart attack (judging also from the overall coronary calcium burden, expressed as coronary calcium score), in the future 5 to 10 years.
But, turning to your specified questions, I would explain as follows:
(1) The standard procedure of A coronary angio CT is performed by a trained medical imagine technologist, and after an optimal acquisition and three dimensional reconstruction of the imagine data, this information is transferred to a certified imagine specialist doctor (radiologist or cardiologist) which reviews the entire examination and gives the final exam report.
It is quite impossible to be an error of the machine, as the test is performed in a standardized lab. When the overall calcium score is 101 - 400 this is considered a moderate evidence of coronary artery disease (CAD). If > 400 it is judged as extensive evidence of CAD.
2) Coronary CT is performed in apparently normal individuals even without any clinical simptomatology (who may have possible coronary risk factor) to predict future possible coronary events (by showing evidence of CAD) and thus modifying several life-style and dietary issues to prevent such events from happening. It is quite possible to have such high overall calcium score even without any complains.
Remember that coronary calcium scores are most informative in a man between 40 and 60 years in terms of providing information about cardiovascular risk. Men over 80 years almost all have high Calcium Scores and therefore such a scan would not provide any useful information.
So coming to your case, your high calcium score is a bit difficult to give clear conclusions about about a reliable prediction (given your age).
3) As I said you above, I don't believe your coronary CT results will yield any immediate need for any emergent additional diagnostic tests or interventional invasive procedures.
Nevertheless, it remains on your attending doctor discretion to make the decisions. You just need to discuss with your doctor about a scheduled strategy for preventing further coronary risk factors in the future.
4) A more invasive coronary test, such as coronary angiography is optional, not a clear indication. As I said you before, the majority of adult patients over 75 years old will have increased coronary calcium scores on coronary CR exam.
5) Facing your age, your totally asymptomatic clinical conditions, it is recommended just a careful coronary risk factors prevention and treatment program, and of course a close medical follow-up.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello!
Thank you for asking on HCM!
Regarding your concern, I would like to explain that deciding to perform a coronary CT, the reason is to predict approximate relative risk of having a heart attack (judging also from the overall coronary calcium burden, expressed as coronary calcium score), in the future 5 to 10 years.
But, turning to your specified questions, I would explain as follows:
(1) The standard procedure of A coronary angio CT is performed by a trained medical imagine technologist, and after an optimal acquisition and three dimensional reconstruction of the imagine data, this information is transferred to a certified imagine specialist doctor (radiologist or cardiologist) which reviews the entire examination and gives the final exam report.
It is quite impossible to be an error of the machine, as the test is performed in a standardized lab. When the overall calcium score is 101 - 400 this is considered a moderate evidence of coronary artery disease (CAD). If > 400 it is judged as extensive evidence of CAD.
2) Coronary CT is performed in apparently normal individuals even without any clinical simptomatology (who may have possible coronary risk factor) to predict future possible coronary events (by showing evidence of CAD) and thus modifying several life-style and dietary issues to prevent such events from happening. It is quite possible to have such high overall calcium score even without any complains.
Remember that coronary calcium scores are most informative in a man between 40 and 60 years in terms of providing information about cardiovascular risk. Men over 80 years almost all have high Calcium Scores and therefore such a scan would not provide any useful information.
So coming to your case, your high calcium score is a bit difficult to give clear conclusions about about a reliable prediction (given your age).
3) As I said you above, I don't believe your coronary CT results will yield any immediate need for any emergent additional diagnostic tests or interventional invasive procedures.
Nevertheless, it remains on your attending doctor discretion to make the decisions. You just need to discuss with your doctor about a scheduled strategy for preventing further coronary risk factors in the future.
4) A more invasive coronary test, such as coronary angiography is optional, not a clear indication. As I said you before, the majority of adult patients over 75 years old will have increased coronary calcium scores on coronary CR exam.
5) Facing your age, your totally asymptomatic clinical conditions, it is recommended just a careful coronary risk factors prevention and treatment program, and of course a close medical follow-up.
Hope to have been helpful to you!
Feel free to ask me whenever you need! Greetings! Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Attaching the report. Does this say anything more?
Brief Answer:
A healthy diet and life style profile are helpful.
Detailed Answer:
Hi again!
As I said you before, considering your asymptomatic clinical status, and your current age; coronary CT calcium score would not be too much useful, as almost all individuals of that age have increased calcium scores.
This CT report is helpful to focus more attention on attending a healthy life style and diet profile; as well as periodic medical follow-ups of your health conditions.
Wish you a good health! Dr. Iliri
A healthy diet and life style profile are helpful.
Detailed Answer:
Hi again!
As I said you before, considering your asymptomatic clinical status, and your current age; coronary CT calcium score would not be too much useful, as almost all individuals of that age have increased calcium scores.
This CT report is helpful to focus more attention on attending a healthy life style and diet profile; as well as periodic medical follow-ups of your health conditions.
Wish you a good health! Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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