Incidental CT finding calcium in Left Main

[jarus]

My husband had a CT of his abdomen (probablysmall bowel IBD) and the Radiologist mentioned calcium seen in LMCA with clinical correlation. He does not have any symptoms and is 43 yrs.  Will this test give valuable information that may eliminate the need for a cath? What is the recommended treatment for LMCA narrowing currently?? CABG or stents??  Thank you

[Darcy Green Conaway, MD]

Coronary calcium is an overall marker of plaque burden--- the higher the score the more plaque present. He should officially have a calcium score done and if >100 consider further noninvasive testing. The calcium seen does not mean he needs to go to the cath lab but he certainly needs further evaluation and very aggressive risk factor modification: he needs to not smoke (if he does), needs to be at an ideal body weight, and to have well controlled cholesterol. Treatment of disease in the left main is dependent on how diseased it is. It's possible that he has calcium there but that the blockage is not severe enough to warrant either....he needs further evaluation by a cardiologist.

[jarus]

My husband's CT showed a calcium score of 117 and says he is highly likely to have moderate non-obstructive CAD.  What is the next step usually??  Cath or other?  Thank you