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Cardiac ❯ CAC (Coronary Artery Calcium Scoring)

ProblemCAC (Coronary artery calcium scoring)
ProtocolCT scans were performed in cranio-caudal direction during inspiratory breath-hold with prospective electrocardiogram (ECG)-triggering. CAS is a non contrast CT with a low radiation dose and is a 5 minute study with no patient prep. The scan range is from below the aortic arch to the base of the heart.
Pearls1.CAC scoring is currently recommended for use in asymptomatic individuals to predict the risk of developing cardiovascular diseases and the disease-specific mortality. In
specific subsets of patients, the CAC score has also been recommended for reclassifying cardiovascular risk and aiding in decision making when planning primary prevention interventions such as statin therapy.
2. There are currently three CAC scoring methods: Agatston score,
volume score, and mass score . Of these three CAC scoring methods, the Agatston method is the most validated
and widely used in practice, thereby serving
as the reference standard.
3. Potential pitfalls that can confound calcium score calculations include coronary artery motion artifacts, noncoronary calcifications,
streak artifacts from adjacent metallic prostheses, and inclusion of patients who have undergone coronary artery stent placement or coronary artery bypass graft placement.
4. Relatively recent Society of Cardiovascular Computed Tomography guidelines recommend
repeat CAC scoring at 5 years for patients with an initial CAC score of 0 and at 3–5 years for
patients with a CAC score higher than 0, provided that the development or progression of CAC leads
to an intensification or alteration in preventive management.
5. the MESA scoring system is routinely used. It can be found at 
6. we also dictate the extracardiac findings which can reveal unsuspected pathology including lung cancer

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