Can this be cured by angioplasty

[vkk1951]

A CT angiography shows Coronary Artery Calcium score of 16.6.
The right dominant system shows type 1 LAD with eccentric calcified plaque inn the proximal LAD causing mild (approx.20%) stenosis and a fibrous plaque in the mid LAD causing moderate (approx.55%) stenosis. Fibrous plaque in the proximal LCX causing moderate(approx.55%) stenosis. Long segment fibrous plaque in the mid and distal RCA causing moderate (approx. 60%) stenosis.
Do I need to undergo a cath angigraphy to understand the exact extent of the blockage ? If yes and in case the blockage levels are correct, can they be cleared through angioplasty ?

My BP ranges from 130-140/80-85, my cholestrol level is around 150, triglycerides 85, HDL-cholestrol 36, LDL cholestrol 94, VLDL cholestrol 17 and Cholestrol : HDL ratio at 4.10.

[kenkeith]

A ct scan (64-slice) angiogram provides information regarding the anatomy of coronary vessels and that includes the soft plaque within the lining outside the lumen.  It is this soft plaque that can lead to and is high risk for an infarct.  The soft plaque can rupture through the lining into the lumen and forms a clot that can lead to a heart attack.  The ct scan software calibrates a calibrates a score based on the degree and location of the soft plaque as well as within the lumen.  There is a score for RCA, LM, LAD,  CXC and total.  My total score was 1207.1 and that indicates high risk for a heart event within a year.  Your 16.6 score (total or ?) is very low probability and of little risk for a heart event.  

Also, a ct scan (mine) included a view of the lungs and the abdomen that includes the decending aorta.  You do not need any interventional procedure as there is sufficient information provided by the ct scan.

[ed34]

I was always under the impression that a CT was just as accurate as an Angiogram. In
fact a CT can pick up more information. An angiogram procedure can only pick up what
is seen by the dye being injected into the arteries. If a complete artery is blocked, then
nothing will show up on the screen, whereas a CT scan will reveal it.
The big difference between an angiogram and CT scan is that if something like a large
blockage is seen, it can be treated on the spot during an angio. Obviously this is not
the case with the CT scan because no catheter is used.
I really urge you to try and manage your stress levels. It is this that will worsen your
condition whether you have very high cholesterol or very low cholesterol. Just remember
that life is too short to worry about and no job is worth killing yourself over. Most people
who have suffered heart attacks suddenly wake up to that reality but it's a shame it takes such a thing to make you realise.

[vkk1951]

Thanks for your revert. Yes I do have a stress full job and have tried to maintain my cholestrol level low thinking that will not lead to blockages. I am told that CT angio is only indicative and the reults may vary from a normal angio - it could be less or more than that indicated by a CT angio. Is this so ?

[ed34]

Trigs - 85mg/dl = 85/88.57 = .95 mmol/l  this is a great level
HDL - 36mg/dl = 36/38.67 = 0.9 mmol/l this is a bit low, you want > 1
LDL - 94mg/dl = 94/38.67 = 2.4 mmol/l this is a great level

You need very slightly more HDL but .9 is not at all bad. Your bad cholesterol and
trigs are at the levels expected of someone to reach who has had heart problems.

As long as your plaque occlusions do not reach 70% then any angina experienced
should be manageable by medication. Try to picture your coronary arteries as a tunnel
built for a train which is 12m wide. The tunnel is more like 36m wide so there is a lot
of extra room. The 60% blockage may require treatment in the future, or they may decide
to act now, different doctors have different opinions. An Angiogram will reveal the same
blockages as the CT scan. An Angiogram only reveals vessels which allow the dye to
flow through, a CT scan will pick up all the vessels regardless. One of my grafted veins
didn't show on an angiogram, they looked for 30 minutes and couldn't find it. It showed
up fine on the CT scan.
May I ask you a question, do you lead a fairly stressful life? is your line of work stressful?  Your cholesterol is very low and seems to reinforce independant studies
stating there is no relationship between cholesterol levels and Coronary Heart Disease.