Coronary CTA questions, please explain in as much detail as possible, thank you very much!

From the perspective of coronary CTA, coronary heart disease, two lesions can be diagnosed, but it is not excluded that the left main trunk also has mild stenosis, preliminarily the stenosis of the two coronary arteries is about 60-70%, but to know the accurate degree of stenosis, you have to look for information from the coronary CTA, generally in the background data processing of coronary CTA, you can improve the calculus method to calculate the approximate degree of stenosis, you can ask them if they have this technical processing, I just can't see these data with the naked eye here. If there is a typical angina attack, it is best to do coronary stent intervention as soon as possible. If there are no symptoms, you can first be conservative in internal medicine**, and the first choice is statin drugs (only statin lipid-lowering drugs, the effect of the so-called lipid-lowering Chinese patent drugs is uncertain), and long-term application can reduce cardiovascular and cerebrovascular events by more than 30%-40%; Nitrates should also be used (heartache, Xinkang, etc.), which can dilate the coronary arteries and improve blood supply and symptoms; Antiplatelet drugs such as aspirin and/or clobidogrel are also used, which can prevent arterial infarction and hopefully reduce the incidence and size of infarction.

These drugs are indispensable drugs, but also to actively ** hypertension, diabetes and other primary diseases, so, if there are the above diseases, the relevant drugs are also a must, in addition to the musk Baoxin pills, compound Danshen dripping pills, Xinda Kang and other **coronary heart disease of the Chinese patent medicine to choose one as an auxiliary**, but also to emphasize diet control, quit smoking, appropriate exercise and regular review is also indispensable, if the effect is good, it has been a long-term conservative **, if the effect is not satisfied, you have to consider coronary intervention** Finish. I wish you well.

The examination is not too accurate, there is only a longitudinal section of the blood vessels, and there is no cross-section of the blood vessels. So that there is no detailed data on the maximum narrow cross-section! If you are given a disc for examination, it is best to go to the examination hospital to make up the cross-sectional analysis of the blood vessels!

The overall feeling is that the maximum narrow cross-section is still very serious!

Not severe, mild to moderate stenosis requires only medication**. Pay attention to control blood lipids and blood pressure, eat lightly, control weight and mood, exercise appropriately, take aspirin in small doses, and take some vasodilators such as pear isonitrate and other drugs if you have symptoms. If there is severe stenosis of more than 75% and blood flow is not smooth, a stent can be implanted to dilate the blood vessels.

Hello, for your questions, let's talk about them one by one:

1. The reporting method of CTA stenosis is different in each hospital, which is generally divided into 4 grades I, II, III, IV, corresponding to the stenosis of -75% and >75%, the mild stenosis is about 20%, and the mild-moderate stenosis is about 40%. Because it is generally a visual assessment, there will be some differences in the degree of stenosis between different doctors, but the difference will not be very large, and it will not affect the ** principle. Generally speaking, at the age of 63, such blood vessels are quite acceptable, not particularly serious, and need to be well maintained.

2. Plaques are divided into soft plaques, calcified plaques, and mixed plaques, the soft plaques are lipid cells in the fiber cap, and the calcified plaques are the calcium salt deposits in the plaques, so the density on CT is different, and the mixed plaques are in between. Soft plaques are prone to ACS (acute coronary syndrome) due to the fragility of the fibrous caps, so plaque stabilization drugs are required. Although the calcified plaque is structurally stable, if it develops to the point of PCI** in the future, it will cause great problems for surgery.

3. Judging from the current results, there is no problem with conservative **, and the lumen stenosis has not reached the level of stent implantation. At least two of these medications should be taken for life: 1) aspirin 100 mg once a day; 2) Statins:

Lipitor 20mg qn orally or coxidine 10mg qn orally. Receptor blockers can be added as appropriate depending on blood pressure and heart rate to reduce angina pectoris and adverse cardiovascular events. Nitrates may be used if symptoms of angina are frequent, but this degree of stenosis is usually asymptomatic.

In addition to the above measures, it is also important to improve lifestyle habits, pay attention to rest, avoid fatigue, full food, emotional agitation, infection, etc., quit smoking and limit alcohol, control weight, blood pressure, blood lipids, blood sugar, low-salt and low-fat diet, etc. Also, the ** you passed is too small, I can't see the degree of stenosis clearly, but the calcification can be seen very clearly, the left main trunk, the proximal circumflex branch, and the middle anterior descending artery are more serious, and there will be no discrepancy with the results on the report. However, these severe calcifications are located at the bifurcation, and it will be tricky to deal with if it develops in the future, so please be sure to take good care of it at ordinary times, and if you have symptoms, please see a doctor in time, good luck!

1. The stenosis of the above situation is not too serious, it should be about 50%;

2. There are three kinds of plaques: calcified plaques, atherotic plaques, and lipid plaques, and calcified plaques are rusts such as those in boiling kettles;

Mixed plaques are plaques that include more than two types;

3. You can use Danshen Dripping Pill and Tongmai Shu No. 3 to completely dissolve the plaque and dissolve it from the body.

1 Stenosis is less severe, less than 75% do not consider stenting.

2. **First of all, determine the stenosis **, you can do a comprehensive intracardiac examination, and then you can formulate a **plan, according to the situation you said, you can consider conservative**, the common ones are aspirin, Polivix, atorvastatin, etc.

3. Check the relevant information for the explanation of calcified plaques and mixed plates.

Abnormal results: CTA (CT angiography) can be used to diagnose Takayasu's arteritis, arteriosclerosis occlusion, aortic aneurysm and dissection and other symptoms to help clinical diagnosis. People who need to be examined: Patients with cardiovascular disease.

Hello, your mother-in-law is 60 years old this year, in the last two days, she has shown symptoms of rapid heart beating and some back pain in the hospital, and the doctor recommended a coronary CT examination, the main purpose of the examination is to determine whether there is coronary artery stenosis. Therefore, if your mother-in-law needs to have a coronary CT examination, consider that it may be due to coronary heart disease, and the heart rate may be due to coronary heart disease. Coronary CTA is a kind of cardiac vascular examination method, it is examined under CT, the method of examination is to develop the coronary artery through intravenous contrast medium, so as to determine the degree of coronary artery stenosis, and decide the next step according to the examination results.

The main concern for coronary CTA is the need for aspiration and air-holding. It is necessary to determine whether the patient has diabetes mellitus, severe hyperthyroidism, or allergy to iodine contrast before the examination, and this test cannot be done if there is severe hyperthyroidism and patients who are allergic to iodine contrast media. If you are taking metformin, you need to stop taking the drug for 48 hours before you can do this test, and if the test results show that the coronary artery is more than 75% stenosis, further hospitalization for imaging will be recommended to see if a stent is needed**.

1. If the breathing control is not done well, this CTA report is unreliable, and various degrees of stenosis can only be used as a reference.

2. If there are calcified plaques, coronary atherosclerosis can be determined, but it is not certain whether there is coronary heart disease.

3 If you look at this report alone, it cannot be called coronary heart disease, because there must be at least one moderate stenosis, but there are multiple mild stenosis, and long-term anticoagulation should be noted**.

4. It is recommended to be conservative** first, and then do a CTA examination in about half a year to 1 year, and pay attention to poor respiratory control, no one can accurately diagnose.