Health Awareness Society

 SAMPLE IMAGES AND SIGNIFICANCE OF RESULTS

   CAUTION: The discussion which follows is general in nature. The information provided herein should not be used to diagnose individual cases. Every case is unique and only a doctor is qualified to diagnose and prescribe treatment. Furthermore, it's important to realize that no test in medicine should be viewed in isolation. The patient obtains the greatest benefit when test results are place in the context of an overall medical profile, and typically, it is the patient's personal physician who is best able to do this.

NEGATIVE SCAN (NO IDENTIFIABLE ATHEROSCLEROTIC PLAQUE)

   A negative scan is the best possible test result. It means that no calcium was found in the coronary arteries. Accordingly, it is highly unlikely that the patient has a significant (greater than 50%) coronary artery narrowing. While a negative test result does not guarantee that the patient will never experience any cardiac problems, it should prove greatly comforting that advanced atherosclerotic plaque is not yet present. Patients with negative scans should, of course, understand that this excellent test result does not provide a license for irresponsible behavior with respect to diet, exercise, smoking, weight, blood pressure and cholesterol control, etc. Adopting and/or maintaining excellent health habits increases the likelihood that the coronary arteries will remain "clean" for as long as possible.

 MINIMAL PLAQUE BURDEN

   Small amounts of calcified plaque have been found in the coronary arteries, which means that the disease process has begun. This is not a reason to panic. Most individuals in Western Civilization will build some level of disease as they age. While it should always be the goal to stabilize or reverse this disease process, the reality is that slowing its progression and preventing it from reaching an excessive level is often sufficient to allow one to live a long and healthy life free of cardiac problems. Patients with this level of disease are advised to consult with their physician to develop a risk modification program to include adopting a low-fat diet, cardiovascular exercise, stress management and smoking cessation programs, and achieving optimal weight, blood pressure and cholesterol levels. In addition, aspirin therapy should be considered.

 MILD PLAQUE BURDEN

   Scores in this range indicate that mild atherosclerotic plaques are present. The likelihood that significant coronary disease is present is low. Active risk factor modification in these patients is critical to prevent the disease from progressing to a more advanced state. In addition to general public health guidelines for prevention of cardiovascular disease (adopting a low-fat diet, cardiovascular exercise, stress management and smoking cessation programs), strict adherence to National Cholesterol Education Program guidelines for cholesterol-lowering should be followed (total cholesterol should be reduced to less than 200 mg/dl and LDL cholesterol should be reduced to less than 130 mg/dl). In addition, aspirin therapy should be considered.
  

 MODERATE PLAQUE BURDEN

   Scores in this range indicate the likely presence of moderate non-obstructive coronary stenoses (narrowings). Very aggressive risk factor management in a physician-supervised program is strongly recommended. In addition to general public health guidelines for prevention of cardiovascular disease (adopting a low-fat diet, cardiovascular exercise, stress management and smoking cessation programs), strict adherence to National Cholesterol Education Program guidelines for cholesterol-lowering should be followed (total cholesterol should be reduced to less than 200 mg/dl and LDL cholesterol should be reduced to less than 130 mg/dl). In addition, aspirin therapy and exercise testing to rule out ischemia should be considered.

 EXTENSIVE PLAQUE BURDEN

   Scores in this range indicate the presence of advanced atherosclerosis. There is a high likelihood of the presence of at least one coronary stenosis (narrowing) greater than 50%, and the patient is at a high risk of having an acute coronary event or developing symptomatic heart disease. In addition to general public health guidelines for prevention of cardiovascular disease (adopting a low-fat diet, cardiovascular exercise, stress management and smoking cessation programs), strict adherence to National Cholesterol Education Program guidelines for patients with established coronary artery disease should be followed (LDL cholesterol should be reduced to less than 100 mg/dl). In addition, stress testing with either nuclear imaging or echocardiography to rule out ischemia should be strongly considered, as should the institution of aspirin therapy.