Coronary CTA

A coronary CTA (also called CT coronary angiography) is a study of the inside of your tiny heart vessels performed without going inside your heart. In the past, noninvasive functional tests of the heart were used, such as treadmill tests and nuclear studies, to indirectly assess if there were blockages in the coronary arteries. The only way to directly look at the coronary arteries was via a cardiac catheterization or coronary angiogram.

This new screening test facilitates examination of the inside of your tiny heart vessels non-invasively, made possible with a more advanced generation of CT scanner, which is able to scan the entire heart during five heartbeats. A normal or only mildly abnormal CT scan makes the likelihood of a severe blockage of the coronary arteries quite small, while if your CT scan is significantly abnormal, cardiac catheterization and angiography will likely be recommended as a next step to determine which treatment - typically angioplasty, stenting, or coronary bypass surgery - is indicated.

Who should consider a coronary CTA?

This procedure is recommended for people with:

• Intermediate to high-risk profiles for coronary artery disease, but who do not have typical symptoms (especially chest pain, shortness of breath, or fatigue during heavy physical activity.)
• Unusual symptoms for coronary artery disease (such as chest pain unrelated to physical exertion), but low to intermediate risk profiles for coronary artery disease.
• Unclear or inconclusive stress-test (treadmill test) results.

For patients in these categories, coronary CTA can provide important information to your doctor on the extent and nature of plaque formation, with or without any narrowing of the coronary arteries. Coronary CTA is also useful as a non-invasive method to rule out narrowing of arteries as a cause for chest discomfort, and can also detect other possible causes of symptoms.

What should I expect during the test?

Patients undergoing a coronary CTA scan receive an iodine-containing contrast dye as an IV solution to ensure the best images possible. Medication may also be delivered by the IV in the arm to slow or stabilize your heart rate for better imaging results. The exam itself usually takes just ten minutes. During the examination, X-rays pass through the body and are picked up by special detectors in the scanner. The results provide a highly detailed three-dimensional image of the coronary arteries and, if present, plaque in their walls.

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