What Do You Mean By CT Coronary Angiogram Showing Mixed Plaque At The Distal Margin Of The LMCA?

Posted on Sat, 9 Nov 2013

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 9 Nov 2013 Answered on

Sat, 30 Nov 2013 Last reviewed on

Question : I have just had a CT Coronary Angiogram which shows LMCA: There is a small volume of mixed plaque at the distal margin of the LMCA. There is some "noise" and artefact at this site - it is thought to cause a stenosis of >50%. Can you explain what this means?

Answered by Dr. Indu Kumar (-4 hours later)

Brief Answer: Noise and Stenosis are limitations of CT machine. Detailed Answer: Hello Thanks for writing to XXXXXXX According to CT coronary angiography there is a small plaque(due to deposition of fat,foam etc) in the distal part of Left main coronary artery(LMCA).At this site there is also some noise and artefacts which is estimating stenosis of >50%.Noise and artefacts are the technical limitations of CT Scan machine. So,it is overestimating the percentage of stenosis,it is not the actual percentage. You should follow the advice of your cardiologist. Management depends upon clinical findings and reports of other investigations. I presume that other investigations had been already done. CT angiography has some limitations.It is not as sensitive as conventional angiography in stenosis grading.But,it is the best for calcium scoring in coronary vessels. At this stage if you & your doctor is considering for some intervention then stenosis findings should be corroborated with conventional angiography. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Indu Kumar (9 hours later)

Thank you for your answer. It is most helpful. The other result of the angiogram reads : LAD : Type lll LAD. Predominantly non-calcified plaque is seen to involve the proximal and mid LAD; there is up to moderate (50-70%) stenosis just proximal to the 1st major septal perforator bracnhes. Just distal to this, there is further focus of predominantly non-calcified plaque causing mild (approximately 50%) stenosis. D1 : Small/moderate calibre vessel; mild narrowing at the ostium D2 : Mild ostial narrowing: moderate calibre vessel. D3: Moderate calibre, disesase free vessel. Could you explain this result in laymens terms? Thanks.

Answered by Dr. Indu Kumar (16 hours later)

Brief Answer: There are two sites of stenosis in LAD Detailed Answer: Hello Thanks for your query Other angiography reports are 1.There is non calcified plaque in proximal and mid LAD( left anterior descending artery) and it is causing 50-70% stenosis and this site is just before the 1st major septal perforator branches. 2.Just distal to this,there is another area of non-calcified plaque which is causing mild (approximately 50%) stenosis. So,there are two sites of stenosis in LAD which is causing stenosis. D1,D2,D3 are grading of vessels. Get well soon. Hope i have answered your query. Further queries are most welcome. Take Care Dr.Indu XXXXXXX

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar