CT coronary angiogram (normal)

Discussion:

According to Coronary artery disease- reporting and Data System (CAD-RADS), in stable chest pain, this patient is categorized as CAD-RADS 0, no evidence of coronary artery stenosis.

In CAD-RADS, if there is presence of plaque, the vulnerability of the plaque to indicate high risk plaque should be assessed.

The vulnerable plaque includes

1. Positive remodeling
2. Low attenuation plaque (<30HU)
3. Napkin-ring sign
4. Spotty calcium

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