CT of heart

Resolved question:
Hi, I did a CT for my heart. My cardiologist decided I should do one because I complained of occasional chest tightening and palpitations.
The results came today and this what it says (full text):

'Further to our previous correspondence, I am writing to inform you of the results of this patient's CT calcium scoring carried out at London Chest Hospital on 20 December 2013. This showed a calcium score of 0. Although a non-calcified atheroma (and related narrowing) cannot be excluded with certainty, this finding indicates a low probability of severe coronary obstructions. There is mild aortic root calcification.

There was no significant extra cardiac abnormality identified.

As the patient is not awaiting any further cardiac investigations, I have now discharged him back to your care "

My question, before I visit my GP is the following: Could you please clarify what is 'mild aortic root calcification'? How does it affect me, and what I can do to keep it mild in the future? Any specific diet? (not to worsen it)?

I'd wish to mention that at the time I did my CT, I didn't have any palpitations, but I occasionally I have them, especially if I fill my stomach to the full and lean forward (like it is coming from a stomach pressure of some kind) Not sure the two are related, but I did already mention it to you (I did seek advice on this site couple of months ago).

I'd appreciate if you could comment on my question taking on board the CT results.

Many thanks

Submitted: 4 Days
Category: Cardiologist

Expert:  Dr. Vivek Mahajan replied 4 Days.

Hello,
Thank you for your query at DoctorSpring.com.

There is no medication or precaution to minimize the progression of aortic root or arch calcification. It is an age related change which is inevitable as if now.

The CT scan report of your shows zero calcium. It means the likelihood of you having cad is low. They should have done ct coronary angiography because you are an intermediate risk patient and we needed to find out why you have chest tightness and ct coronary angio would have told us if you have any blockages.

But now that they have done the calcium scoring we know that you dont have large burden if atherosclerosis. But a small non calcified atherosclerotic plaque cannot be ruled out. Ct coronary angiography could have done that. Alternatively, you could go for a treadmill test to rule out any significant coronary artery disease.

Hope this helps, would be glad to answer any follow-ups.
Regards
Dr Vivek Mahajan
DM Cardiology

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Patient replied :

Hi Dr Mahajan,

Many thanks for your reply. I too was a little surprised that they didn't do CT angio since that was on my referral letter. I was also instructed how the needle will be placed etc, so I was ready for it. However, when I got there, the person said that they will first do the calcium score and if they find something they will proceed with the test. Something like that.

I am now refereed back to my GP, so it won't be possible for me to ask for a treadmill test, since that is also done in a cardiologist office. As for my chest tightening I do now think that is due to my bad sleep posture which I corrected lately and I no longer experience any tightening. That said, I will be in Croatia in April so I might do the treadmill test there, privately. It is way more affordable.

When you say I'm an 'intermediate risk patient', do you mean the risk is related to my age?
In addition, is mild aortic root/arch calcification relatively common for my age?


Expert:  Dr. Vivek Mahajan replied 3 Days.

Hello
Calcium scoring is definitely not the test for you as you have symptoms. Ct angio was a better choice
All the best for your tmt or stress test.
You are intermediate risk because of age gender and family history.
If in addition you have diabetes hypertension or dyslipidemia you move further towards high risk.
Stress test is a good option for you.
Mild aortic root calcification may be seen in middle aged people but is mote common from 6th decade onwards
Regards
Dr Vivek Mahajan

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Patient replied :

Hi, many thanks for your reply.
I will do the tmt test, as well as echocardiogram because it is a part of the package, so to speak, in the clinic. Do you think I should benefit from echo test, or it is not necessary at this point?


Expert:  Dr. Vivek Mahajan replied 2 Days.

Yes. I think its good to have a echo report too.
Regards
Dr Vivek Mahajan

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