Aortic atherosclerosis on a CT report, and the coronary line beside it

The words next to it

Words you may see beside aortic atherosclerosis on a report, and what each one changes.

Atherosclerotic calcification, calcified plaque

The same finding in other words. Calcium is one of the things plaque is made of, and it's the part that shows up bright on CT.

Mild, minimal or scattered

The lighter words: the radiologist saw a small amount of calcified plaque.

Moderate, dense or extensive

More calcified plaque. In a 2022 review of calcium in the aortic arch, a heavier load went with a higher risk of heart and blood vessel events and of death from any cause.

Aortic arch, thoracic or descending aorta

The plaque is in the part of the aorta inside the chest. An ordinary chest CT can judge this well, so it shows up on many chest reports.

Abdominal aorta, infrarenal, aortoiliac

The plaque is in the belly part of the aorta, seen on an abdomen or pelvis CT. Infrarenal means below the kidney arteries, and aortoiliac means where the aorta splits toward the legs.

Normal caliber, no aneurysm

The aorta is a normal width and isn't ballooned out anywhere.

Dilated, ectatic or aneurysmal

The aorta is wider than normal somewhere. Plaque can weaken the aortic wall and raise the risk of an aneurysm, and a wider aorta is a separate finding the doctor follows on its own.

What usually follows when the aorta is a normal width

The plaque line sends the doctor to the risk factors behind it. Providers "use blood tests to check cholesterol, triglycerides, blood sugar, and lipoprotein levels", and they check blood pressure too.

In MESA, a large US study, the people who developed new calcium in the chest aorta were more often older, had higher systolic blood pressure (the top number), took blood pressure medicine, or smoked.

When the coronary arteries are on the same report

A chest CT report may fold both into one sentence, like "atherosclerotic calcification of the aorta and coronary arteries." Both are calcified plaque. The coronary arteries are the smaller vessels that supply the heart muscle itself, and calcium there is a marker of coronary artery disease, linked to a worse outlook.

UK heart and radiology societies grade incidental coronary calcium on chest CT as none, mild, moderate or severe. Their consensus also says it's "not necessarily an indication for further imaging or referral to a cardiologist" and recommends a review of symptoms and risk factors instead.

The aorta line adds some information about heart risk too. But a 2024 study found that aortic calcium on chest CT "does not replace CAC on ECG-gated cardiac CT", meaning a coronary calcium score from a dedicated heart scan. A doctor may still suggest that scan for some people.

Questions to ask the doctor

• How much calcification did the radiologist describe, and does that change anything for me?
• Did this scan also show calcium in my coronary arteries, and how was it graded?
• When were my cholesterol, blood sugar and blood pressure last checked, and are they where they should be?
• Does this change whether a cholesterol or blood pressure medicine makes sense for me?
• Would a coronary calcium scan tell us anything useful in my case, or is this handled at regular check-ups?

Often on the same report

• Coronary artery calcification

  Calcium has built up in the walls of the heart's own arteries. Calcified plaque is a sign of atherosclerosis (coronary artery disease), which raises the risk of a heart attack, and more calcium generally means higher risk. It doesn't show whether an artery is narrowed.

• Atherosclerotic plaque

  A sticky buildup inside an artery made of cholesterol, fat, blood cells, calcium and other substances. Over time it hardens and narrows the artery, which can limit blood flow.

• Aortic aneurysm

  A balloon-like bulge in the wall of the aorta, the body's main artery. Most cause no symptoms. A large one can burst or tear the artery wall, so treatment depends on its size and how fast it's growing.

• Incidental finding

  Something the scan happened to show that wasn't what the test was looking for. Many have no bearing on health at all. Some are worth a closer look, and whether anything more is needed is the doctor's call.

• Tortuous aorta

  The aorta, the body's main artery, takes a more winding, curving path than usual. In the chest this is a common finding in older adults.

• Ectatic aorta

  The aorta, the body's main artery, is somewhat widened, but not enough to be called an aneurysm. Radiologists also use the word for the curving chest aorta that's a common finding in older adults.

Questions people ask

What is plaque in the aorta?

It's a buildup of cholesterol, fat, blood cells, calcium and other substances from the blood along the wall of the aorta, the body's largest artery. Doctors also call it aortic atheroma.

Is aortic atherosclerosis common?

Yes, and it gets more likely with age. In MESA, a large US study of adults, 27% of participants already had calcium in the chest aorta when the study began.

How to reduce arterial plaque?

Treatment aims to slow it down rather than remove it. The list for aortic atherosclerosis includes lifestyle changes and medicines such as "statins to manage your cholesterol", blood pressure medicine, and anti-clotting medicine.

What does the medical abbreviation "AAA" stand for?

AAA stands for abdominal aortic aneurysm. It means the aorta has become very large or ballooned out somewhere in the belly. It's a different finding from plaque, and a report that says "normal caliber" or "no aneurysm" is telling you it wasn't seen.

Other phrases explained: Pulmonary nodule · Ground-glass opacity · Schmorl's node · Bone marrow edema