Some other coronary artery conditions can rarely cause chest pain with low or zero calcium score and CT angiogram may not be helpful except in case of coronary artery dissection. I can say the probability of atherosclerotic coronary vascular disease as the cause of chest pain is very low or almost nil with a calcium score of zero but other causes of angina pectoris can't be ruled out entirely.
Answered 2/25/2023
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No, a calcium score will not rule heart related conditions that can cause chest pain, will make one mechanism/ ischemia less likely. There are inflammatory heart conditions more likely at your age, such as pericarditis or myocarditis among many others for which a calcium score will be useless in diagnosis.
Answered 2/28/2023
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