The Zero Calcium Score Paradox

Rachad Ghazal; Danish Bawa; Adnan Ahmed; Dhanunjaya Lakkireddy; Vasvi Singh

doi:10.1016/j.jaccas.2024.102233

The Zero Calcium Score Paradox

JACC Case Rep. 2024 Feb 5;29(5):102233. doi: 10.1016/j.jaccas.2024.102233. eCollection 2024 Mar 6.

Authors

Rachad Ghazal¹, Danish Bawa¹, Adnan Ahmed¹, Dhanunjaya Lakkireddy¹, Vasvi Singh²

Affiliations

¹ Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, Kansas, USA.
² Midwest Heart and Vascular Specialists, HCA Midwest Health, Overland Park, Kansas, USA.

Abstract

Our study presents a case of angina with a zero calcium score yet severe coronary stenosis from noncalcified plaque. We highlight the limitation of otherwise prognostically powerful coronary calcium score as a singular predictive tool especially when used in symptomatic patients.

Keywords: CTA coronary angiography; arterial plaque; coronary artery calcium score; coronary artery disease; coronary atherosclerosis; coronary calcification.