What is coronary artery calcification? Do I need treatment? When we have a chest CT, we often see the words “coronary calcification” in the findings in addition to lung conditions. In the past, calcification could not be seen on conventional CT, but nowadays, thin layer chest CT can see coronary calcification in the heart. So, what exactly is the meaning of coronary calcification and is there any harm? What exactly does coronary calcification suggest? A. What is coronary calcification? How can I see it? Coronary calcification in CT films refers to the small bright spots (calcification points) distributed along the coronary arteries in CT. The coronary artery is the blood vessel that supplies blood to the heart muscle, and what we often call coronary heart disease refers to the myocardial ischemia, myocardial infarction and heart failure caused by the narrowing and blockage of this coronary artery. Second, what is the cause of coronary artery calcification? Risk factors for coronary artery calcification (i.e., aggregation of calcified plaque seen on Ct) include: identified risk factors for heart disease, such as male, older age, poor glucose tolerance, tobacco use, dyslipidemia (lipoprotein metabolic disorders, which include hypercholesterolemia), hypertension, obesity, etc. Third, is coronary calcification equivalent to coronary stenosis? Mautner et al. observed that 54% of coronary segments with >75% stenosis showed coronary calcification on CT, while only 41%, 23% and 6% of stenotic lesions with 51%-75%, 26%-50% and 1%-25% stenosis showed coronary calcification, respectively. However, coronary calcification is not equivalent to severe coronary stenosis, and coronary calcification, suggesting that the patient may have coronary stenosis. Fourth, what further tests do patients with coronary calcification need to have? Coronary calcification also depends on the degree and the patient’s symptoms. If the calcification is only a punctate calcification on the coronary artery, most of the problems are not serious at this degree. If the calcification is long and widespread, and if the patient has previous symptoms of chest tightness and chest pain, the possibility of coronary artery disease should be suspected. In this case, it is generally recommended to do a coronary CT first, which is a fine view of the coronary vessels. Through coronary CT (coronary CT is a non-invasive test, similar to conventional enhanced CT, which requires contrast), it is possible to initially assess whether there is any stenosis in the coronary arteries of the heart. If the coronary CT indicates a coronary stenosis of >75%, further testing may be required, such as a more accurate coronary angiogram or placement of a coronary stent. Coronary angiography is an invasive test that is done through a catheter and an interventional procedure to evaluate the coronary arteries (the patient needs to be cannulated in a large vessel and done under radiological examination). To summarize, coronary calcification is only a CT imaging performance. Once this performance occurs, firstly, do not over-interpret it and do not over-stress it, it is not equivalent to coronary heart disease, but patients with symptoms or older patients with high blood lipids are recommended to have a coronary CT for further examination.