✓In people without symptoms and low risk, CT angiography often shows findings that don’t change treatment but increase worry. ✓Managing blood pressure, cholesterol, sugar, and lifestyle prevents heart attacks more effectively than a CT scan. ✓If symptoms worsens  or risk increases, we can safely do advanced imaging later,but right now, benefits don’t outweigh risks.

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In asymptomatic individuals with low–moderate risk, a CT coronary angiogram (CTCA) is generally not recommended as a routine screening test. Father: Controlled hypertension is one risk factor, but if he has no symptoms (chest pain, breathlessness, reduced exercise tolerance) and no multiple risk factors (diabetes, smoking, strong family history, high cholesterol), CTCA is unlikely to provide additional benefit. Mother: A normal echocardiogram is reassuring. Echo assesses heart structure and function, not coronary blockages, but in the absence of symptoms, further imaging is usually not required.

Unfortunately CT angiogram does not prevent future episodes. Equally CT angiograms are not indicated in asymptomatic patients. Even if CT angiogram seemed okay, coronary events are dynamic events. So the focus ought to be on 1. Good blood pressure control 2. Lipid management 3. Screen for diabetes and treat accordingly 4. Screening for hypertension related kidney issue (Renal function test and Urine ACR/PCR) 5. Active life style 6. Smoking cessation and alcohol moderation Goal is to reduce risk of all vascular events (strokes, heart attacks and circulation problems to limbs along with sudden cardiac deaths) All the best. J G S R clinic

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