CAD-RADS is a standard scoring system for CT coronary angiography reports. Learn what each score from 0 to 5 means and what usually happens next.
CAD-RADS (Coronary Artery Disease Reporting and Data System) is a simple 0 to 5 scale that summarises how narrowed the heart arteries are on a CT coronary angiography. A score of 0 means no plaque, and 5 means total blockage. It helps your doctor decide the next step.
Why Does CAD-RADS Exist?
Earlier, CT reports used different words, which could confuse patients and doctors. CAD-RADS gives one common language. The score is based on the most severe narrowing found in any coronary artery, and the report also lists modifiers for stents, bypass grafts, high-risk plaque and non-diagnostic images. Read how CTCA works.
CAD-RADSNarrowingUsual meaning00 percentNo plaque, very low risk11 to 24 percentMinimal narrowing225 to 49 percentMild narrowing350 to 69 percentModerate narrowing470 to 99 percent (or left main 50 percent or more)Severe narrowing5100 percentTotal occlusionWhat Each Score Usually Means for You
- 0: no plaque; focus on prevention.
- 1 to 2: mild plaque; lifestyle and risk factor control, often with a statin.
- 3: moderate narrowing; medicines, and possibly a stress test to see if it limits blood flow.
- 4: severe narrowing; often a cardiology review and further tests or angiography.
- 5: total blockage; specialist review for viability and options.
Modifiers You May See in the Report
- N: non-diagnostic, parts not clear.
- S: stent present.
- G: bypass graft present.
- V: vulnerable (high-risk) plaque features.
These do not mean disease is worse; they add information. See coronary plaque types and CTCA after stent or bypass.
What CAD-RADS Does Not Tell You
The score does not show how you feel, how strong your heart muscle is, or the exact treatment you need. Two people with the same score may need different plans, based on symptoms, age, diabetes and other tests. Treat the score as a guide to discuss with your cardiologist, not a verdict. See how accurate CT coronary angiography is.
A Practical Example
Hari, 58, gets a CTCA report with CAD-RADS 3 in the LAD artery. His doctor explains it is moderate narrowing. He is started on medicines, advised to walk daily and gets a stress test, which is normal. He continues medical treatment and follow-up. Another person with CAD-RADS 4 and strong symptoms is advised an angiography. The same system led to different, suitable plans.
Quick Summary
- CAD-RADS runs from 0 (no plaque) to 5 (total blockage)
- The score reflects the worst artery narrowing
- Modifiers give extra details such as stent or non-diagnostic images
- Your cardiologist decides the next step
Questions to Ask Your Doctor
- Which artery has the narrowing and how much?
- Do I need medicines, a stress test or angiography?
- How often should I repeat the scan?
- What lifestyle changes matter most for me?
Common Mistakes to Avoid
- Comparing your score with others, since every case differs.
- Ignoring follow-up after a mild score.
- Stopping medicines when you feel well.
Booking, Timing and Report
Book a morning slot if possible, since fasting and avoiding caffeine are easier. Carry your latest ECG, echo, TMT, cholesterol and creatinine reports and a medicine list. Allow 45 to 90 minutes at the centre. Reports are usually ready within 24 to 48 hours, because heart images need careful review.
Key Facts at a Glance
- CAD-RADS 0 means no plaque; 5 means total blockage
- The score reflects the most narrowed artery
- Modifiers add details such as stents and image quality
- Lifestyle and medicines matter at every score
Why Follow-Up Matters
Even with a mild score, plaque is a sign that your arteries need care. Regular exercise, a heart-healthy diet, no tobacco and good control of sugar, pressure and cholesterol can slow plaque growth. Take medicines as prescribed and review with your cardiologist at the interval advised.
Frequently Asked Questions
What does CAD-RADS 0 mean?
No plaque and very low risk of heart disease.
Is CAD-RADS 3 serious?
It means moderate narrowing and needs treatment and follow-up, not panic.
Is CAD-RADS 4 an emergency?
Not usually, but it needs prompt specialist review.
What does the modifier N mean?
Some parts of the images were not clear enough.
Can the score change?
Yes, with treatment and lifestyle, the plaque can stabilise.
Does a high score mean surgery?
Not always. Medicines and stents are other options.
Is CAD-RADS the same as a calcium score?
No. Calcium score measures calcium; CAD-RADS measures narrowing.
Who explains the score?
Your cardiologist.
Should I repeat the scan?
Only if your doctor advises. See CTCA report time and next steps.
Book Your Test at Ganesh Diagnostic
Ganesh Diagnostic & Imaging Centre in Rohini, Delhi offers this test with trained radiology staff and clear reports. You can book an appointment online, check our branches across Delhi NCR, contact us for current rates, or explore all our services. Reports can be downloaded online through our patient portal, so you do not need to make a second trip just to collect them.
This article is for general information only. It does not replace advice from your doctor. Always follow your doctor's instructions for your test.
