Triphasic Injection Protocol – Patient with Extensive Proximal Coronary Artery Disease

In this retrospectively gated full thoracic CT study, the examination was performed using the LightSpeed VCT 64 system with 0.625 mm detector collimation, retrospective cardiac gating and mono-sector reconstruction. The patient received three 5 mg injections of Metoprolol intravenously for cardiac rate control. Heart rate during acquisition was 64 to 65 BPM.

All bypass grafts (Figures 2 and 3) are normally patent. Curved planar reformations and thin-section MIPs document patency of the arterial and venous bypass grafts, the appearance at the implant site and the native distal coronary circulation.
There is extensive proximal coronary artery calcification and an indeterminate degree of proximal stenosis/occlusion in the major coronary arteries.

An incidental finding is a distal submucosal esophageal lesion, a probable leiomyoma.