Coronary Ct Angiography; Mayfair Diagnostics: Fill & Download for Free

Imagine the following, not so uncommon scenario:A patient has recurrent attacks of chest pain on exertion (angina), typical of coronary artery disease. The cardiologist suggests a coronary angiography with the possibility of angioplasty and stent implantation, which will get rid of the symptoms. The patient is informed about the fact that they will have to take more blood thinners (antiplatelet drugs to be exact) after the stenting than they did before.Lab work-up shows that the patient is also suffering from anaemia, which is actually making the chest pain worse. A simple test shows blood in the stool. The doctor suspects a stomach or a colon tumour and insists that the patient has a gastroscopy and colonoscopy first, explaining to the patient that a colon tumour could still be benign, small and amenable to endoscopic resection, which would be more dangerous if the patient had already had the coronary stenting and had already been placed on two antiplatelet drugs. On the other hand, doing nothing about the gastrointestinal problem could lead to life-threatening bleeding and/ or the spread of cancer.The patient refuses, because he/ she has no gastrointestinal complaints and sees no blood in the stool. After the informed consent has been signed, the angiography is performed, which reveals a severe conorary artery disease, so that a stent is placed in the left main stem coronary artery.Under the therapy with the two antiplatelet drugs, the patient develops a life threatening gastrointestinal bleeding, so that the antiplatelet drugs have to be discontinued. The CT-angiography reveals an advanced tumour of the colon as the cause of the bleeding, typical of colon cancer. An urgent hemicolectomy (partial colon resection) is scheduled, but the patient dies the day before because of cardiac arrest due to thrombosis (clotting) of the stent in the left main stem coronary artery after discontinuation of the antiplatelet drugs.The family wants to sue the cardiologist about not having communicated the bleeding risk adequately before proceeding with the angioplasty and stent implantation. After expensive legal advice, they decide to drop the charges.Colonoscopy of the patient’s children reveals a familial disposition to colon cancer. All tumour precursors in the children can be removed endoscopically, so that no surgery and no chemotherapy are needed.Why did the cardiologist initially refuse to treat the patient’s very real symptoms of chest pain? What did he have to gain, apart from patient health and freedom from a malpractice suit and all its implications? A clear conscience, I guess.

For an accurate evaluation coronary angiography which is an invasive test but if blockages are found they can be managed by angioplasty / by pass surgery.Then there is cardiac CT, which is good screening for blocks but no Cardiologist will manage the blocks on Coronary CT report. They will ask for coronary angiography.

The coronary artery calcium score is an established way to measure the status of the coronary arteries in term of risk to develop a heart attack. Coffee Consumption and Coronary Artery Calcium Score: Cross-Sectional Results of ELSA-Brasil (Brazilian Longitudinal Study of Adult Health). In the above link a research group used this CT calcium score to measure the effects of coffee consumption. 3 cups of more of coffee was associated with 67% less hardening of the coronary arteries than no coffee consumption.