Cardiac CT Angiography and Calcium Scoring

What Is a Cardiac CT Scan?

A traditional CT scan utilizes a procedure that combines many x-ray images and uses a computer to create three-dimensional views of the body. A Cardiac CT Scan uses a state of the art multi-row detector CT (MDCT) scanner that obtains thousands of images of the heart and blood vessels within a single breath hold. This technology can be used alone to assess hardening and calcification of your coronary arteries or in conjunction with intravenous contrast dye (CT Angiography) to visualize the circulation of the heart. This latter approach can also be used to visualize the great vessels of the neck, chest, abdomen and legs.

Calcium Scoring CT Scan

This test uses the technology discussed above to visualize calcium deposits in the coronary arteries. Calcium deposits can be a sign of coronary artery disease. The amount of calcium does not correlate directly with the narrowing of a single artery, but does correlate with the overall severity of plaque (atherosclerosis) in the coronary arteries. Multiple studies have now shown that the coronary calcium score can predict the future risk for suffering from a heart attack or stroke. Coronary Artery calcium screening may be performed by itself or (more usually) in conjunction with Cardiac CT Angiography.

What to Expect

A Nurse will contact you prior to the exam to screen you for any contraindications to the exam.

On the day of the exam a nurse/technician will assist you to change into a hospital gown, and lie on the exam table. Sticky electrodes will be placed on your chest (similar to those used during an EKG) to record your heart rhythm during the test. During the scan you will feel the table move into the scanner.

You will be instructed to take a deep breath and hold it for approximately twenty (or less) seconds. It is important you remain as still as possible during the exam. The scan itself takes about ten minutes but preparation for the exam can take up to fifteen minutes so please allow yourself about an hour for the procedure from start to finish including the registration process. After the exam you may eat and drink as usual, and resume all normal activity.

Cardiac CT Angiography

This exam is a fast, accurate, non-invasive, reliable method used to visualize the coronary arteries within a single breath hold. Cardiac CT Angiography is used to evaluate the coronary arteries for blockages, abnormalities, and to assess previous coronary artery bypass grafts for patency.

What to Expect

A Nurse will contact you prior to the exam to screen you for any contraindications to the exam.

Your physician, or our Nurse Practioner will order a blood test to check your kidney function. This can be done at a lab of your choice, or at your physician's office. This test is necessary to make sure your kidney function is normally, as the IV contrast is excreted from your body by your kidneys. This blood test must be performed within 3-6 weeks of your scheduled examination. On the day of the exam, a nurse will assist you to change into a hospital gown, and lie on the exam table. Sticky electrodes will be placed on your chest (similar to those used during an EKG) to record your heart rhythm during the exam. An intravenous line will be started and you may be given medication intravenously called a beta-blocker and sublingual nitroglycerin to slow the heart rate and dilate the arteries in order to obtain the best possible images. You will then be positioned inside the scanner. You will be instructed to take a deep breath and hold it for approximately 15-20 seconds. It is important you remain as still as possible during the exam. During the scan you will feel the table move into the scanner. The simultaneous injection of intravenous contrast may induce a sensation of warmth and a metallic taste in your mouth. This is normal and will abate in one to two minutes.

The scan itself takes is a single breath hold, but preparation for the exam can take up to thirty minutes so please allow yourself about an hour for the procedure from start to finish including the registration process. As soon as the exam is completed, the intravenous will be removed and you may leave. You may eat as usual and resume all normal activity. Please drink plenty of fluids (we recommend up to 2 liters) during the remainder of the day to assist your kidneys in flushing the contrast out of your system.

Exam Results

Using a sophisticated computer program the images will be reconstructed and analyzed by our specialized team of cardiologists. The results will be sent to your referring physician. Your referring physician will discuss the results of the exam with you.

Risks of CT

A CT scan is a low risk non-invasive procedure. CT scanners use x-rays to obtain images. For your safety, radiation exposure is kept to a minimum.

 CTA uses intravenous contrast; occasionally this can cause an adverse reaction such as itching, and/or rash. Antihistamines, such as benadryl, can be administered for relief. Rarely, a more serious reaction can occur which can cause difficulty breathing. This may be life threatening,and require medication, and/or treatment to reverse the symptoms. Please note that our specialized team is trained in the management of these situations and will act immediately and efficiently on your behalf. In addition, pre-exam screening by our staff helps minimize your risk of potential complications.