Coronary computed tomography angiographic findings and recommended management

(A) No coronary atherosclerosis. Excellent prognosis. Management: Reassurance. Symptoms non-atherosclerotic in nature.
(B) Non-obstructive (<50% stenosis; unlikely flow limiting) coronary artery disease (arrow). Symptoms likely not atherosclerotic in nature. Management: Preventive pharmacotherapy, risk factor modification and lifestyle changes. Patient risk is higher if multiple segments and/or high-risk plaque features (refer to UpToDate text).
(C) Moderate stenosis (50 to 69% stenosis; dashed arrow). Symptoms possibly atherosclerotic in nature. Medical management if non-proximal location. Consider CT-FFR if proximal location or considering revascularization for symptom benefit. Aggressive cardiovascular risk factor modification.
(D) Obstructive (likely flow-limiting) coronary artery disease. Management: Symptom-guided anti-ischemia therapies, including revascularization, per guidelines. Preventive pharmacotherapies.