Coronary computed tomography

Coronary computed tomography (CCT) allows high resolution imaging of coronary atherosclerosis, coronary artery stenosis, and other coronary pathology or anomaly, such as abnormal origin of coronary arteries or myocardial bridging. Coronary artery calcium (CAC) imaging to quantify calcified plaque or CT angiography (CTA) to detect calcified, mixed, or non-calcified plaque may help to improve risk stratification and exclusion of coronary artery disease, especially in master athletes with present or past cardiovascular risk factors or athletes with atypical chest pain. Initial data suggest that the extent of subclinical atherosclerosis may be underestimated in athletes and that an increased atherosclerosis burden is associated with impaired prognosis. Careful risk–benefit assessment of radiation exposure, contrast agent, and costs of the test is necessary, particularly for asymptomatic athletes with risk factors and young athletes.