Core IM | Internal Medicine Podcast #44 Coronary Calcium Score and CTAs: 5 Pearls Segment
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Jul 10, 2019 Explore the crucial differences between functional stress tests and anatomical cardiac tests. Delve into the role of coronary artery calcium scores in managing coronary artery disease and their implications for risk stratification. Learn how coronary CT angiography compares with traditional stress tests and when to avoid using CTA. The discussion also highlights effective communication strategies for conveying CTA results to patients, ensuring clarity in their treatment options.
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Two Sides of the Coin
- Coronary disease testing has two main categories: functional and anatomical.
- Functional tests assess ischemia, while anatomical tests reveal plaque burden, offering a comprehensive view.
Calcium Scoring Basics
- Coronary calcium scores, derived from non-contrast CTs, quantify coronary plaque burden using Hounsfield units.
- Higher scores indicate greater risk, but age, race, and gender must be considered using tools like the MESA calculator.
Calcium Scoring Use Cases
- Avoid using calcium scoring for chest pain evaluation; it only detects calcified plaque, not "soft" plaques.
- Reserve calcium scoring for asymptomatic patients with intermediate risk to assess statin benefit and leverage the "power of zero."