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What is a reasonable approach to coronary calcification that is incidentally found on CT in a patient who does not have symptoms suggestive of angina?

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How do you manage incidentally found asymptomatic coronary calcification on a CT scan in a patient without symptoms of angina?

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3 Answers
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Cardiology · Allegheny General Hospital
Answered on

This patient needs aggressive medical therapy and risk factor modifications. Statins will be the primary lipid-lowering agent but other agents as needed to get an LDL under 70. Hypertension needs to be identified and controlled. Aspirin is also a consideration depending on the extent of coronary cal...

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Cardiology · Hunterdon Cardiovascular Associates
Answered on

I look at the patient's age and other risk factors. For instance, if it is a 75-year-old female non-smoker with scattered Ca++, then there probably is no data for primary prevention with statins or ASA - but it might depend on the LDL.

I am willing to use qualification as opposed to "quantification"...

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Cardiology · Langhorne Cardiology Consultants Inc
Answered on

I agree with the rest of the comments. This has become the most common cause of referrals in my office. Unfortunately, the primary physicians order this test on many patients and every calcification (most of the patients) will generate a cardiology referral. As a cardiology community, we have a long...

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