What Coronary CT Angiography Is
CT angiography is an imaging exam that uses x-rays to examine the blood vessels in various parts of the body.
A scanner is used to take images which are assembled into three-dimensional views of the blood vessels using state-of-the-art computer software. When used to view the arteries of the heart, this exam is referred to as coronary CTA (or cardiac CTA).
Catheter angiography has been used to examine coronary arteries for years. With catheter angiography, a very thin, long tube is threaded through the groin arteries to the heart. Coronary CTA is a much less invasive procedure.
A negative result from a coronary CTA is a strong indicator that the patient does not have coronary artery disease. Because the test is non-invasive, coronary CTA will likely become the first line diagnostic test to evaluate for the presence or absence of coronary artery disease. In patients with acute cardiac symptoms or angina, however, catheter angiography is still preferred because intervention, such as stenting a narrowed artery, can be performed at the same time.
Coronary CTA may be helpful in patients with unclear causes of chest pain, which is a common patient complaint in doctors’ offices and emergency rooms. There are many causes of chest pain and they can be difficult to tell apart. CT angiography may help to rule out the most dangerous causes of chest pain, such as blockage or abnormality of a coronary artery, a pulmonary embolism, or an aortic aneurysm or dissection. In addition, sometimes stress test results are uncertain. In these cases, CT angiography can evaluate the coronary arteries and spare the patient a surgical angiogram.
Following are some additional circumstances under which coronary CTA may be used:
- Detection of subclinical heart disease as the basis for primary prevention
- Pre-surgical assessment of coronary arteries
- Evaluation of coronary artery abnormalities
- To check the openness of a stent or bypass graft
- Coronary CTA does have limitations. It is not able to image people with irregular heart rhythms. Very obese patients or those with heavily calcified arteries may also not benefit from this exam.
Benefits of Coronary CTA
Following are some of the benefits of having a coronary CTA over other exams for evaluating a person’s risk of heart attack:
Coronary CTA is able to detect small amounts of plaque that are missed by other exams. Consequently, it can detect very early disease before a patient has symptoms.
Coronary CTA allows the radiologist to evaluate other organs near the heart and possibly find other abnormalities, such as lung disease or enlarged lymph nodes. More than one in ten scans will have such findings.
Coronary CTA allows the radiologist to view the blood vessel walls. With catheter angiography, only the lumen (the opening where the blood flows, like the center of a hose) can be examined. The lumen can often look normal when the blood vessel has actually expanded to compensate for plaque buildup.
The exam is performed at the following RIA partner hospitals in the Denver, Colorado area:
- Medical Center of Aurora
- Porter Adventist Hospital low radiation option available
- Sky Ridge Medical Center
- Swedish Medical Center