Coronary Computed Tomographic Angiography
What is Coronary Computed Tomographic Angiography? Coronary Computed Tomographic Angiography (CCTA) is a heart-imaging test used to determine whether fatty deposits or calcium deposits have built up in the coronary arteries, the vessels that supply oxygen-rich blood to the body. If left untreated, these areas of build-up can lead to coronary atherosclerosis, which can restrict or block blood flow.
- Who should be tested with CCTA?
- How should you prepare for your procedure?
- How does the procedure work?
- How is the procedure performed?
- What will you experience during and after the procedure?
- How do you get your results?
- What are the benefits of CCTA?
- What are the risks of CCTA?
- What are the limitations of CCTA?
- How can you get tested?
CCTA is useful in patients who do not have typical symptoms of coronary artery disease (CAD) such as chest pain, shortness of breath or fatigue during heavy physical activity, but are still at risk for the disease. This includes patients who have any of the following risk factors.
- Abnormally high cholesterol levels
- A family history of heart disease
- High blood pressure
- Cigarette smoking
- Being overweight or obese
- Being physically inactive
CCTA could also be recommended for other patients, including those who:
- Are thought to have abnormal coronary arteries
- Have chest pain not brought on by exercise
- Have unclear or inconclusive stress test (treadmill test) results
How should you prepare for your procedure?
You may be required to have routine lab work including a blood draw prior to your scan. Tell your doctor if you are taking any medications or have any allergies, especially if you are allergic to contrast or X-ray dye. Also, tell your doctor if you have diabetes, kidney disease or could be pregnant.
- 36 hours before your scan, do not take any medications for erectile dysfunction (Viagra, Cialis or Levitra).
- 12 hours before your test, do not eat or drink any caffeinated food or beverages including coffee, chocolate, tea, energy drinks or soda).
- Your doctor may ask you to take a beta blocker medication to lower your heart rate the night before your test.
- If you are diabetic and on insulin, your doctor will inform you of the recommended dosage to take the morning of your scan.
- You will need to fast for 4 hours before your exam and drink two 8-ounce glasses of water 1 hour before you arrive for your scan.
- You should wear comfortable, loose-fitting clothing. You will be given a gown to wear during the procedure.
- Metal objects including jewelry, eyeglasses, dentures, hearing aids and hairpins should be removed before the scan.
If you have any questions about the instructions given to you, ask your doctor before undergoing the test.
During the exam, X-rays pass through the body and are picked up by special detectors in the scanner. You may be given a contrast material or dye that will help to clearly define the blood vessels during the scan.
A nurse will place an IV in your arm to administer the contrast material or dye during your procedure. You will also be given a dose of nitroglycerin to help dilate the arteries in your heart.
You will lie on a table, and the technologist will place small electrode patches on your chest. These electrodes are attached to an ECG monitor that records the electrical activity of your heart.
The table will move through the scanner to determine the correct starting position. The table will move through again as the actual CT scanning is performed.
You may be asked to hold your breath for 10 to 15 seconds while images are recorded. Any movement could cause the images of your heart and blood vessels to blur.
When the examination is complete, you will be asked to wait until the technologist verifies that the images can be accurately interpreted. Once this is confirmed, your IV will be removed.
CT scans are painless, fast and easy. You may, however, experience some discomfort from having to lie still for several minutes. Also, if you are claustrophobic, uncomfortable or have chronic pain, your doctor can prescribe a mild sedative to help relax you.
- If you are given contrast material, you will feel a slight pin prick from the needle for the IV. You might feel a warm sensation during the injection and have a metallic taste in your mouth. This will only last for a few minutes.
- If you are given a beta blocker to slow your heart rate, there is a chance you may feel dizzy if you stand suddenly.
- You will hear only slight buzzing, clicking and whirring sounds during the imaging process.
- You will be alone in the exam room during the scan, but the technologist will be able to see, hear and speak with you at all times.
After the CT scan, you can return to your normal activities. You may be given special instructions if you received contrast material.
A cardiologist and radiologist will study your images and send a report to your primary care or referring physician. If you are experiencing chest pain at the time of your scan, a preliminary result can be reported immediately.
What are the benefits of CCTA?
- The procedure is non-invasive and your recovery time is quicker compared to other procedures.
- The exam is fast and simple. It should last about 15 minutes.
- You can have the scan even if you have an implanted medical device such as a pacemaker.
- There are no side effects from the X-rays used in the exam.
- The test might eliminate your need for surgery. If you do need surgery, it can be performed more accurately.
What are the risks of CCTA?
- There is a small risk of cancer from prolonged, repeated exposure to X-rays. The radiation dose from this procedure, though, is about the same as what you would receive from radiation (radiation that is constantly present in the environment from natural or artificial sources) over a two to four year time period.
- CT scanning is not recommended for pregnant women because of potential risk to the baby.
- Nursing mothers should wait 24 hours after receiving contrast material before breast feeding.
- There is a slight risk of an allergic reaction to the contrast material. This is very rare, and the CT department is equipped to handle an allergic reaction.
What are the limitations of CCTA?
This particular piece of equipment has a weight limit. Please check with your physician about any limitations. Patients who are extremely overweight or have abnormal heart rhythms might not be eligible for the test because their images may not be clear enough for a diagnosis.
CCTA will only provide physicians with a diagnosis. Another procedure may have to be performed for treatment. Not all health insurance plans cover CCTA. Please talk to your doctor if you have any questions about your insurance coverage.
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