Related Experiment Video

Updated: Sep 1, 2025

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
04:40

Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans

Published on: August 28, 2018

15.3K

Monckeberg calcification of coronary arteries: a string of pearls

Blair L Tilkens1, Tarek Ajam1, Marc Atzenhoefer1

  • 1Aurora Cardiovascular and Thoracic Services, Aurora Sinai/Aurora St. Luke's Medical Centers, Advocate Aurora Health, University of Wisconsin School of Medicine and Public Health, 2801 W. Kinnickinnic River Parkway, Ste. 880, Milwaukee, WI, 53215 USA.

Radiology Case Reports
|August 15, 2022
PubMed

Insights

High coronary artery calcium scores on CT scans do not always indicate blocked arteries. This case highlights extremely high calcium scores with nonobstructive coronary arteries found on angiography.

Area of Science:

  • Cardiovascular imaging
  • Radiology
  • Preventive cardiology

Background:

  • Coronary artery calcium (CAC) scoring is a key tool for cardiac risk stratification.
  • Noncontrast cardiac-gated computed tomography (CT) is used to calculate CAC scores.
  • CAC scores estimate the extent of atherosclerosis in the coronary arteries.

Observation:

  • A patient presented with an extremely high coronary artery calcium score.
  • Subsequent coronary angiography revealed nonobstructive coronary arteries.
  • This discrepancy between CAC score and luminal obstruction was noted.

Findings:

  • The study presents a case of a significantly elevated CAC score.
  • Angiography demonstrated no significant luminal narrowing in the coronary arteries.
  • This indicates a potential disconnect between calcification burden and obstructive disease.

Implications:

  • Elevated CAC scores may not always correlate with hemodynamically significant coronary artery disease.
  • Rethinking the interpretation of CAC scores in specific clinical contexts may be necessary.
  • Further research is needed to understand the implications of high CAC scores without obstructive disease.

Keywords:
AngiogramComputed tomographyCoronary artery calcium scoreMonckeberg calcification

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