Coronary Artery Calcification Advice and Guidance
Coronary calcification
If the patient is known to have coronary artery disease (previous myocardial infarction, abnormal coronary angiogram, coronary angioplasty or stenting or coronary artery bypass grafting) and is already taking secondary preventative measures, no further action is necessary.
If the patient has no prior diagnosis of coronary artery disease, they should be offered an appointment in primary care to discuss any symptoms and review their risk factors for coronary artery disease.
Asymptomatic patients with mild or moderate coronary calcification should have their risk factors treated according to standard primary prevention guidelines. If the calcification is described as severe, we would recommend using secondary prevention guidelines and targets.
Patients with symptoms should be referred for a routine cardiology clinic appointment through ERS, unless they have recent (within the last six weeks) onset of symptoms, or rapidly worsening symptoms, in which case they should be referred to a rapid-access chest pain clinic. All symptomatic patient should be started on aspirin 75mg OD, simvastatin 40mg ON, bisoprolol 2.5mg OD and GTN spray PRN (unless there are contra-indications) and given safety-netting advice about action to take in the event of unexpected or prolonged chest pain.
Aortic valve calcification
If the patient is known to have aortic stenosis no further action is necessary.
If the patient is not known to have aortic stenosis, they should be offered an appointment in primary care to discuss any symptoms.
Patients with exertional symptoms (breathlessness, chest pain or dizziness) should be referred for an urgent cardiology outpatient clinic appointment through ERS.
Patients with good exercise tolerance and no symptoms should be referred for a routine local open-access echocardiogram.