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Version October 2024
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Coronary computed tomography angiographic findings and recommended management
Coronary computed tomography angiographic findings and recommended management
(A)
No coronary atherosclerosis.
Excellent prognosis. Management: Reassurance. Symptoms non-atherosclerotic in nature.
(B)
Non-obstructive (<50% stenosis; unlikely flow limiting) coronary artery disease (arrow).
Symptoms likely not atherosclerotic in nature. Management: Preventive pharmacotherapy, risk factor modification and lifestyle changes. Patient risk is higher if multiple segments and/or high-risk plaque features (refer to UpToDate text).
(C)
Moderate stenosis (50 to 69% stenosis; dashed arrow).
Symptoms possibly atherosclerotic in nature. Medical management if non-proximal location. Consider CT-FFR if proximal location or considering revascularization for symptom benefit. Aggressive cardiovascular risk factor modification.
(D)
Obstructive (likely flow-limiting) coronary artery disease.
Management: Symptom-guided anti-ischemia therapies, including revascularization, per guidelines. Preventive pharmacotherapies.
CT-FFR: computed tomography derived fractional flow reserve; LAD: left anterior descending coronary artery; RCA: right coronary artery.
Courtesy of Todd Villines, MD.
Graphic 129599 Version 1.0
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