High calcium score in an 83-year-old patient with non-ST elevation acute coronary syndrome and nonobstructive coronary artery disease: a case report

Currently, multi-slice computed tomography (MSCT) coronary angiography is a leader in the diagnosis of coronary artery disease in patients with non-ST elevation acute coronary syndrome of low or moderate risk. High coronary calcium score (CCS) obtained by MSCT indicate a high probability of obstructive coronary artery disease. In the presented case of an 83-year-old patient with unstable angina, the CCS was 1394, and hemodynamically significant stenoses were detected. However, according to selective coronary angiography, no hemodynamically significant coronary lesions were found. High CCS suggests poor image quality in MSCT coronary angiography. High CCS is detected in most people over 70 years of age. Obviously, in this patient, a high CCS is mainly determined by age. Most studies on CCS did not include patients over 80 years of age. When deciding whether to perform MSCT coronary angiography, it is necessary to take into account the individual characteristics of a particular patient, which may affect the interpretation of results.