The article discussed in the last post, also talks about the use of CT angiography in the follow-up of patients with known coronary artery disease, but who are on medical management. This is a reasonable indication and especially in India, where many patients opt for alternative therapies, include naturopathy, chelation etc. this probably becomes even more relevant.
This 58-years old asymptomatic man came last week for a cardiac CT. He had a catheter angiogram done for an episode of angina last year (Figs. 1, 2). It showed severe proximal circumflex (Cx) stenosis with occlusion of the mid-Cx beyond the OM1 origin, the Cx filling up through a collateral from the LAD. The RCA and LAD were normal, except for a proximal PL stenosis. Since the dominant RCA and LAD were normal, it was decided not to intervene. The cardiac CT done last week showed no change in the appearance of the PL (Fig. 3, 4) and Cx (Fig. 5) disease with a virtually normal LAD (Fig. 6).