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Human Health Campus
Human Health Campus
Human Health Campus

Atypical pain with positive CTA and normal MPI

2012
Teaching Case

Case presentation:

  • Female.
  • 51 y.o.
  • Heavy family history of CAD, no other known risk factors.
  • Episodes of atypical chest discomfort. - Positive exercise test.
  • Submitted for CT angiography (CTA), reported as:Severe proximal LAD stenosis, no other lesions, Ca score >1000.

Teaching points:

  • CTA is sensitive for detecting CAD, however the technique has limited value in predicting the degree of stenosis.
  • Especially in the presence of arterial calcifications, it is sometimes difficult to assess the characteristics of a coronary lesion by CTA.
  • Calcium score >300 is associated with poor accuracy of CTA results (incomplete evaluation of coronary tree).
  • Myocardial perfusion has powerful prognostic value and is not affected by calcium score.

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