Here is an image from a CT coronary angiogram showing the aorta (the main blood vessel coming out of the heart and bringing blood to the body) with the coronary arteries coming off the aorta and going around/to the heart – the heart has been removed from the image so we can see the vessel, much like is seen on a heart catheterization. These arteries show no significant narrowings.[/caption]
Now that we’ve covered CT coronary calcium scores, we’d like to talk more about noninvasive heart imaging.
There are several ways of studying artery narrowing or blockages of the coronary arteries of the heart. Two common exams are the CT angiogram of coronary arteries and the coronary angiogram, also known as a heart catheterization or “heart cath.”
For a CT angiogram, radiologists use CT technology and intravenous contrast to noninvasively image the arteries. A heart catheterization, usually performed by a cardiologist, uses a small catheter threaded through the blood vessels to the heart to inject contrast into the arteries. The exam may require light sedation, and the use of catheters in the heart has risks including but not limited to blood vessel damage, arrhythmias, bleeding and stroke.
It has been shown that 40% of heart catheterization procedures in women and a smaller percentage in men are normal. In those cases, nothing is wrong with the arteries and nothing requires treatment like angioplasty or stenting. Having a less invasive, safer exam to evaluate people at risk for heart disease or symptoms of heart disease is a bonus - particularly for those patients with lower risk and potentially normal coronary arteries.
CT angiography of the coronary arteries uses CT, EKG, intravenous contrast and sophisticated 3D post processing techniques to create 3D images of the heart and heart arteries for analysis. Both soft plaques and calcified arterial plaques can be imaged and analyzed for severity. The determination for noninvasive or invasive treatments can be made from this study. The procedure takes approximately 30 - 60 minutes, requires little preparation and the results are shared with the ordering physician for further review.
For patients at high risk for coronary artery disease, or those likely needing intervention such as angioplasty (treating narrowed arteries with a balloon) or stenting, a traditional heart catheterization is recommended. This allows diagnosis to be followed by immediate treatment.
CT coronary angiography can be considered for the following patients among others:
- Patients with a strong family history of heart disease.
- Patients with multiple risk factors for heart disease such as hypercholesterolemia, hypertension, diabetes.
- Patients with atypical chest pain.
Talk to your medical provider if you have questions regarding this examination or questions regarding your personal risk for heart disease.
Originally published 2/14/14 on diagnosticimagingcenterskc.com.