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What does ""cardiac silhouette appears to be without calcifications" mean?

Apr 2013
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General Surgeon
Practicing since : 2008
Answered : 9331 Questions
When a radiologist writes regarding a CT angiogram that the "cardiac silhouette appears to be without calcifications," is he saying there are no coronary artery blockages in his view? If so, why wouldn't he simply state the percentages, i.e., the LAD has 0% blockage. It sounds vague.
Posted Wed, 26 Mar 2014 in General Health
Answered by Dr. Ivan R. Rommstein 29 minutes later
Brief Answer: hi and welcome to hcm Detailed Answer: Thanks for the query. Well, cardiac calcifications dont refer only to coronary calcifications. Calcifications can be seen in aorta, valves,myocard or pericard so it is good for you that there is nothing seen on cardiac silhouette. Coronary calcifications indicate coronary atherosclerosis but the exact percentage of blockage cant be so easily determined without coronarography. So if there are no calcifications it doesnt mean that there is no atherosclerotic plaque or some minor blockage so we cant say it is 0% blockage.
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Follow-up: What does ""cardiac silhouette appears to be without calcifications" mean? 14 minutes later
I was under the impression that a CT angiogram actually did determine the percentage of the blockages. I know that a catheterization is the gold standard but I thought the CT angiograms were supposed to be highly accurate these days in identifying blockages. I guess my main concern is this -- the cardiologist reads the report and makes no suggestions for further tests so I assume he feels the CT angiogram doesn't indicate significant CAD. Is that a dumb assumption?
Answered by Dr. Ivan R. Rommstein 9 hours later
Brief Answer: hi Detailed Answer: Ct is hoghly specific,thats true and considering this finding you dont have to be worried. Radiologist is usually not the one who should recommend further tests and treatment plan, but I agree that coronarogrpahy is not necessary if there is no pathology seen on ct angiogram so this is not dumb assumption. CT may miss some minor vessel obstruction but anything significant and symptomatic would be noticed.
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