I'm a retired radiologist with a huge experience performing coronary CT angiography (CCTA). This is an amazingly accurate exam, superior to cardiac catheterization and stress tests. Radiation dose from this exam has been dramatically reduced in recent years,
Having seen thousands of these studies I can state that many people have severe coronary artery disease at young ages (in their thirties). They are at risk for sudden death. Often they come in for the exam because a parent or sibling died prematurely either recently or at the same age as they are now.
What's interesting, in my experience, is that very often when siblings get the exam, the one with obvious risk factors such as obesity, smoking, diabetes, etc has a normal exam result and the sib with no risk factors (other than maybe sharing a bad family history) has severe disease.
We often use coronary CTA to rule out coronary disease in low risk chest pain, but I can't say I would recommend it as a routine test due to the radiation and the dye load. We know that the fatty streak begins in childhood and it must be true that there is a lot of clinically undetected coronary disease. When it comes to sudden cardiac death for a young man, I'd also be concerned about electrical abnormalities such as the Brugada syndrome / channelopathies / accessory pathway syndromes. Drug use is another important factor in general, not that I would think it to be relevant here.
If I have a CCTA test done and it shows early signs of heart disease, what can I do about it? I am 31 healthy, eat relatively good, exercise everyday, don't drink or do drugs. I'm just wondering what you can even really do? Are there (or will there be) drugs that can dissolve the hardened fat (and whatever else) in your arteries?
Having seen thousands of these studies I can state that many people have severe coronary artery disease at young ages (in their thirties). They are at risk for sudden death. Often they come in for the exam because a parent or sibling died prematurely either recently or at the same age as they are now.
What's interesting, in my experience, is that very often when siblings get the exam, the one with obvious risk factors such as obesity, smoking, diabetes, etc has a normal exam result and the sib with no risk factors (other than maybe sharing a bad family history) has severe disease.
Read about CCTA http://goo.gl/o1RvD5