The radiological diagnosis of calcifying coronary sclerosis (author's transl)

Abstract

There has, up to now, not been general acceptance in the German literature of a definite relationship between radiologically visible coronary calcification and coronary heart disease. Anglo-American authors in general agree with our coronographic findings, which show a significantly increased incidence of such coronary changes in stenosing coronary artery disease. In a random sample of patients over 40 years of age, coronary calcification was found radiographically in 25%. Two-thirds of these patients were more than 60 years, but one quarter of the 50 to 60 year age group, and 15% of the 40 to 5-year age group showed these findings. In one group of 150 patients with coronary calcification, 68.9% suffered from coronary heart disease, 7.9% were suspicious and 23.2% had no symptoms. Conversely, in 100 patients with coronary heart disease, coronary calcification was present in 42. Calcification in several vessels was confined almost entirely to patients with advanced coronary disease. Coronary angiography in patients with normal E.C.G.'s, both at rest and after exercise, usually showed some reduction in the lumen corresponding to the area of calcification. In these patients the prognostic significance of the calcification in terms of further development of atherosclerosis must be considered. The localisation of the calcification in these cases is of significance. The clinical features, histology, localisation and investigation of the calcification by radiography is discussed. In our view this has considerable significance in the screening of coronary heart disease.