53 yr old female, former smoker, cholesterol 118, HDL 27,Trig 99,VLDL 20, LDL-CAL 71, overweight, cannot exercise due to shattered bones in foot. Had new 64 slice ct coronary angiogram. Cardiologist that read the report stated that he is new at reading this (hospital has only done the tests on paying patients for 1 week). He reported RCA; technically a dominant vessel which is free of significant disease in its proximal course. in its mid course it tapers off into small vessel that give off a right ventricular branch. Immediately after right vent. branch, right coronary artery appears to be completely occluded. The PDA is seen to fill PROBABLY via left sided collaterals especially the first obtuse marginal branch. He did say that he is not certain of the blockage and may be seeing muscle. Calcium score was 3 - small degree of mild sof plaquing along with specks of calcium in LAD - proximal to the takeoff of the first diagonal brnach. Sof plaue is nonocclusive. Rest of LAD is small but free of significant disease. All other vessels/arteries free of soft plaque and calcium.
Cardio doesn't feel angiogram is warranted at this time. Patient on Toprol 50mg 1 x day, asprin 81 mg 1 x day, Lipitor 10 mg 1xday. ER cardio suggested that this blockage may have happened years ago. Patient is non-symptomatic.
What tests do you think would be warranted for an total blockage?
What risks is this blockage for future heart problems?
How unusual would it be for a calcium score of 3 to have this significant blockage?
Any other information you could add would greatly relieve my anxiety.