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Dr. Andrew Rynne
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Dr. Andrew Rynne

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CT Coronary Angiogram Shows Mixed Plaque. Noted To Be Causing Stenosis. Do I Have To Go For Further Tests?

I have recently done my CT coronary angiogram and it says that there is a mixed plaque in the origin of the left anterior descending measuring 1cm in length, pre stenotic diameter 4mm. This is noted to be causing a stenosis of approximately 50-75%, marked in nature. Minor mixed plaque in the mid LAD is causing a stenosis of appr.25%.Do I have to go for furthur tests? What is my problem?
Mon, 19 Nov 2012
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Cardiologist 's  Response
Hi
Do I have to go for furthur tests ?
answer is YES. you must do routine coronary angiogram .

What is my problem?
you have blockage in your artery which supply blood to the heart and artery which is main artery is LAD
you have blockage at origin of LAD with 50 to 70 % stenosis
in that case routine coronary angiogram should be done to know exact amount of stenosis in lumen and if it is significant amount of blockage in that case you need to go for further tratment .
if blockage is significant and proper treatment not taken in time in that case there are higher chances of having heart attack in future .
consult your cardiologist and go ahead as per his advice .
take care
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Pathologist and Microbiologist Dr. Shailja Puri's  Response
Hello and welcome to HCM
I would like to give you an overview of the topic for better understanding.
Left anterior descending (LAD) coronary artery is an end artery supplying the major part of heart muscles (left heart). End artery means that it is the only artery and there is no other arterial supply for that area.
Any of the following cause- plaque, growth in the vessel, pressure from outside, spasm of the vessel can cause narrowing of the blood vessel.
Narrowing of a vessel due to any cause will increase the vascular resistance and decrease the blood supply to the distal vascular bed.
A critical narrowing is the percentage of narrowing beyond which there is significant reduction of blood supply to the vascular bed.
This critical narrowing is 60-75%.
You have mentioned that you have two plaques- one at the origin of the LAD and it is causing 50-75% marrowing and the other one in the middle of LAD causing 25% narrowing.
The plaque at the origin is causing a critical narrowing and it has to be dealt.
There are various interventions to remove this narrowing- ballon angioplasty, stent placement and arterial by pass surgery.
Please consult your cardiologist for further management.

Thank you and take care
Dr Shailja P Wahal
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CT Coronary Angiogram Shows Mixed Plaque. Noted To Be Causing Stenosis. Do I Have To Go For Further Tests?

Hi Do I have to go for furthur tests ? answer is YES. you must do routine coronary angiogram . What is my problem? you have blockage in your artery which supply blood to the heart and artery which is main artery is LAD you have blockage at origin of LAD with 50 to 70 % stenosis in that case routine coronary angiogram should be done to know exact amount of stenosis in lumen and if it is significant amount of blockage in that case you need to go for further tratment . if blockage is significant and proper treatment not taken in time in that case there are higher chances of having heart attack in future . consult your cardiologist and go ahead as per his advice . take care