Author + information
- Received November 2, 2017
- Revision received February 26, 2018
- Accepted March 20, 2018
- Published online July 2, 2018.
- aDepartment of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio
- bCardiovascular Section, Imaging Institute, Cleveland Clinic, Cleveland, Ohio
- ↵∗Address for correspondence:
Dr. Milind Y. Desai, Department of Cardiovascular Imaging, Heart and Vascular Institute, Cleveland Clinic, 9500 Euclid Avenue, Desk J1-5, Cleveland, Ohio 44195.
Thoracic aortic calcification (TAC) is associated with adverse cardiovascular outcomes, and for the cardiovascular imager, is predominantly encountered in 4 settings: 1) incidentally, for example, during a coronary artery calcium scan; 2) as part of dedicated screening; 3) in the evaluation of an embolic event; or 4) in procedural planning. This review focuses on TAC in these contexts. Within atherosclerosis, TAC is common, variable in extent, and begins in the intima with a patchy distribution. In metabolic disorders, aortitis, and radiation-associated cardiovascular disease, calcification preferentially involves the media and is often more concentric. As an incidental finding, atherosclerotic TAC provides limited incremental discriminative value, and current data do not support screening. After an embolic event, the demonstration of thoracic atheroma provides diagnostic clarity, but has limited treatment implications. Before any procedure, the plan often changes if the most severe form of TAC, a porcelain aorta, is discovered.
↵∗ Drs. Desai and Cremer contributed equally to this work and are joint first authors.
Dr. Desai is supported by the Haslam Family Endowed Chair in Cardiovascular Medicine. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
- Received November 2, 2017.
- Revision received February 26, 2018.
- Accepted March 20, 2018.
- 2018 American College of Cardiology Foundation