Carotid plaque in absence of traditional and non-traditional cardiovascular risk factors.

Carotid plaque is a marker of subclinical atherosclerosis that predicts the presence of coronary artery disease and cardiovascular events. The patient complained of chest discomfort accompanied by ECG abnormalities. Treadmill test demonstrated horizontal ST segment depression, however, coronary angiography did not show any significant stenosis. Carotid plaque was detected by carotid ultrasonogram, despite of the absence of any traditional and non-traditional cardiovascular risk factors, especially normal lipid profiles. This case suggests that unknown determinants of carotid atherosclerosis that we cannot elucidate from the history, physical examination, and common laboratory tests may play a role in the development of carotid plaque.