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Coronary CTA

Coronary computed tomography angiography (likewise called coronary CT angiography or CCTA) uses an injection of iodine-containing contrast textile and CT scanning to examine the arteries that supply blood to the heart and determine whether they have been narrowed. The images generated during a CT browse can be reformatted to create 3-dimensional (3D) images that may exist viewed on a monitor, printed on moving-picture show or by a 3D printer, or transferred to electronic media.

Tell your dr. if there's a possibility you lot are pregnant and hash out any recent illnesses, medical weather, medications you're taking, and allergies. You will be instructed not to eat or drink anything several hours beforehand and to avert caffeinated products, Viagra or similar medication. If you have a known allergy to dissimilarity material, your doc may prescribe medications to reduce the risk of an allergic reaction. These medications must be taken at multiple intervals beginning thirteen hours prior to your examination. Leave jewelry at dwelling and wear loose, comfortable clothing. You lot may exist asked to habiliment a gown. If yous are breastfeeding, talk to your doctor nigh how to proceed.

• What is coronary CTA?
• What are some common uses of the procedure?
• How should I prepare?
• What does the equipment expect similar?
• How does the procedure piece of work?
• How is the process performed?
• What will I experience during and later the process?
• Who interprets the results and how do I go them?
• What are the benefits vs. risks?
• What are the limitations of coronary CTA?
• Which test, procedure or treatment is best for me?

What is coronary CTA?

Coronary computed tomography angiography (CCTA) is a middle imaging test that helps make up one's mind if plaque buildup has narrowed the coronary arteries, the blood vessels that supply the centre. Plaque is fabricated of various substances such as fatty, cholesterol and calcium that deposit along the inner lining of the arteries. Plaque, which builds upward over time, can reduce or in some cases completely block blood menses. Patients undergoing a CCTA browse receive an iodine-containing contrast material as an intravenous (Four) injection to ensure the best possible images of the center blood vessels.

Computed tomography, more commonly known as a CT or Cat scan, is a diagnostic medical imaging exam. Like traditional x-rays, it produces multiple images or pictures of the inside of the torso.

A CT scan generates images that can exist reformatted in multiple planes. Information technology can even generate three-dimensional images. Your doc can review these images on a computer monitor, print them on film or via a 3D printer, or transfer them to a CD or DVD.

CT images of internal organs, bones, soft tissue, and claret vessels provide greater detail than traditional x-rays. This is specially true for soft tissues and blood vessels.

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What are some common uses of the procedure?

Many physicians abet the conscientious use of CCTA for patients who have:

• suspected abnormal beefcake of the coronary arteries.
• low or intermediate risk for coronary avenue affliction, including patients who have chest pain and normal, non-diagnostic or unclear lab and ECG results.
• low to intermediate take a chance singular breast hurting in the emergency department.
• non-acute chest hurting.
• new or worsening symptoms with a previous normal stress test issue.
• unclear or inconclusive stress test results.
• new onset centre failure with reduced middle function and low or medium take chances for coronary artery affliction.
• intermediate risk of coronary artery affliction before non-coronary cardiac surgery.
• coronary artery bypass grafts.

For patients coming together the above indications, CCTA can provide of import information about the presence and extent of plaque in the coronary arteries. Autonomously from identifying coronary artery narrowing as the cause of chest discomfort, it tin can also detect other possible causes of symptoms, such as a collapsed lung, claret jell in the vessels leading to the lungs, or aortic abnormalities. Your primary intendance dr. or cardiac specialist, in consultation with a radiologist who would perform the test, will determine whether CCTA is appropriate for you.

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How should I prepare?

Article of clothing comfortable, loose-plumbing fixtures wear to your exam. You lot may demand to change into a gown for the process.

Metal objects, including jewelry, eyeglasses, dentures, and hairpins, may touch on the CT images. Leave them at domicile or remove them prior to your exam. Some CT exams volition require you to remove hearing aids and removable dental work. Women will demand to remove bras containing metallic underwire. You lot may need to remove any piercings, if possible.

Your physician may instruct you to not swallow or drink anything for a few hours earlier your exam if it will use dissimilarity cloth. Tell your doctor nearly all medications yous are taking and if y'all have whatsoever allergies. If you lot accept a known allergy to contrast material, your doctor may prescribe medications (unremarkably a steroid) to reduce the risk of an allergic reaction. To avert unnecessary delays, contact your doctor well before the date of your exam.

Also tell your doctor nigh any recent illnesses or other medical conditions and whether you have a history of heart disease, asthma, diabetes, kidney disease, or thyroid problems. Any of these conditions may increase the adventure of an agin issue.

On the mean solar day before and twenty-four hours of your exam, you may be asked to avoid:

• diet pills and caffeinated drinks such as coffee, tea, energy drinks or sodas. These may increment heart rate and limit the ability of the test to evaluate for plaque in the coronary arteries.
• Viagra or any similar medication. They are not compatible with the medications you volition receive during the process.

On the night before the procedure, you may be asked to take a beta blocker medication to lower your centre rate to optimize the quality of the exam.

Your child may be asked not to eat or drink anything for several hours beforehand, especially if a sedative or anesthesia will exist used in the test. In general, children who take recently been ill will not exist sedated or anesthetized. If this is the case, or if you lot suspect that your kid may be getting ill, you should talk with your physician about rescheduling the CT exam.

You should besides inform your physician of whatever medications your child is taking and if he/she has any allergies, particularly to intravenous (IV) or oral contrast materials. The allergy information should also be discussed with the CT technologist or nurse at the time of the CT exam. If your child has a known contrast material allergy, y'all should inform the dr. and technologist prior to the exam.

Also inform your doctor of any contempo illnesses or other medical conditions your child may have, and if there is a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these weather may influence the conclusion on whether contrast fabric will be given to your kid for the CT exam.

Talk to your md if you have questions most the instructions y'all've been given.

Women should ever inform their physician and the CT technologist if there is any possibility that they may be meaning. Come across the CT Rubber During Pregnancy folio for more information.

If you are breastfeeding at the fourth dimension of the exam, ask your medico how to keep. It may aid to pump breast milk alee of time. Keep it on hand for use until all contrast material has cleared from your body (near 24 hours later the test). However, the most recent American College of Radiology (ACR) Transmission on Dissimilarity Media reports that studies show the amount of dissimilarity captivated past the infant during breastfeeding is extremely low. For further data please consult the ACR Manual on Contrast Media and its references.

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What does the equipment await like?

The CT scanner is typically a large, donut-shaped machine with a short tunnel in the center. You will prevarication on a narrow table that slides in and out of this brusk tunnel. Rotating around you, the x-ray tube and electronic x-ray detectors are located reverse each other in a band, called a gantry. The computer workstation that processes the imaging information is in a divide control room. This is where the technologist operates the scanner and monitors your exam in direct visual contact. The technologist will exist able to hear and talk to y'all using a speaker and microphone.

CCTA is very much like a normal CT scan. The just divergence is the speed of the CT scanner and the use of a heart monitor to determine your heart rate.

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How does the procedure work?

During the test, x-rays laissez passer through the body and are picked upward by special detectors in the scanner. Typically, college numbers (peculiarly 64 or more) of these detectors result in clearer final images. For that reason, CCTA often is referred to as multi-detector or multi-slice CT scanning. The information collected during the CCTA exam is used to identify the coronary artery beefcake, plaque, narrowing of the vessel, and, in certain cases, eye role. The radiologist will use the estimator to create 3-dimensional images and images in various planes to completely evaluate the heart and coronary arteries.

Procedures employ contrast material to clearly ascertain the claret vessels being examined by making them appear bright white.

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How is the procedure performed?

The nurse will requite you a gown to habiliment during the procedure.

The technologist will make clean three small areas of your chest and identify electrodes (pocket-size, mucilaginous discs) on these areas. Men may require a small area of hair to exist shaved on their chest to assistance the electrodes stick. The electrodes are attached to an electrocardiograph (ECG) monitor, which shows your center'south electrical activity during the exam.

A nurse or technologist will insert an intravenous (4) line into a vein in your arm to administrate contrast material during your procedure. While in the CT scanner, you may be given a beta blocker medication through the same Iv line or past mouth to help slow your heart charge per unit in order to improve epitome quality. Nitroglycerin, to dilate and ameliorate visualization of the coronary arteries, may besides be administered every bit a tablet, a spray underneath your tongue or a patch on your skin.

While lying on the scanning table, you may exist asked to raise your arms over your head for the duration of the exam. This volition help better image quality.

Adjacent, the tabular array will movement quickly through the scanner to make up one's mind the right starting position for the scans. Then, the tabular array will move slowly through the automobile for the actual CT scan. Depending on the blazon of CT scan, the machine may make several passes.

The technologist may inquire you to concur your jiff during the scanning. Any movement, including breathing and body movements, tin pb to artifacts on the images. This loss of image quality tin can resemble the blurring seen on a photograph taken of a moving object.

Inform your physician if you accept issues property your breath for 5 to 15 seconds. Animate during the browse creates blurring on the images and can result in an inconclusive exam.

When the exam is consummate, the technologist volition enquire you lot to look until they verify that the images are of high plenty quality for accurate interpretation by the radiologist.

The doctor or nurse will remove your Four line earlier you go home.

Including all preparations, the CCTA browse usually takes virtually 15 minutes if the centre rate is boring and steady. It may take longer if the baseline heart charge per unit is fast and beta-blocker is given to ho-hum it down. If the beta-blocker is given past mouth it mostly will crave at to the lowest degree one hour to take effect. If the medication is injected into a vein (intravenously), it may withal require multiple doses and up to twenty minutes to accomplish the slower heart rate.

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What will I experience during and after the procedure?

Other than the needle stick when the IV line is placed, most CT exams are fast, easy and painless.

Though the scan is painless, y'all may have some discomfort from remaining still for several minutes or from placement of an IV. If y'all accept a hard time staying still, are very nervous, anxious, or in pain, you may notice a CT exam stressful. The technologist or nurse, under the direction of a medico, may offer yous some medication to help you lot tolerate the CT exam.

If the exam uses iodinated contrast material, your md will screen you for chronic or astute kidney affliction. The medico may administrate dissimilarity fabric intravenously (by vein), and then you will experience a pin prick when the nurse inserts the needle into your vein. You lot may feel warm or flushed every bit the contrast is injected. You also may have a metallic gustatory modality in your oral cavity. This volition laissez passer. Y'all may feel a need to urinate. Withal, these are but side effects of the contrast injection, and they subside quickly.

The medication given to tedious the middle charge per unit has been known to crusade some patients to feel dizzy when they stand suddenly due to a lowering of blood pressure. Therefore, you will often be asked to sit down up slowly on the table prior to standing. The dizziness is slight and only happens rarely. You may also have your claret pressure taken before the exam, during and following the exam if medications are given. The nitroglycerin medication may as well give you lot a headache; this is not dangerous and will wear off chop-chop.

When you lot enter the CT scanner, you may see special light lines projected onto your torso. These lines help ensure that you lot are in the correct position on the exam table. With modern CT scanners, you may hear slight buzzing, clicking and whirring sounds. These occur every bit the CT scanner'south internal parts, not usually visible to you, revolve effectually you during the imaging process.

You volition be lonely in the exam room during the CT scan, unless in that location are special circumstances. For example, sometimes a parent wearing a pb shield may stay in the room with their child. Notwithstanding, the technologist will always exist able to run into, hear and speak with y'all through a built-in intercom organisation.

After a CT exam, the technologist will remove your intravenous line. They will encompass the tiny hole made by the needle with a small dressing. Y'all tin can return to your normal activities immediately.

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Who interprets the results and how do I go them?

A radiologist, a doctor specially trained to supervise and interpret radiology exams, volition analyze the images. The radiologist will ship an official written report to the doctor who ordered the exam.

If you are actively having breast pain, your results will exist given to the emergency room md past the radiologist, and a preliminary consequence volition be reported right abroad.

You may demand a follow-up exam. If so, your doctor will explicate why. Sometimes a follow-upward test further evaluates a potential issue with more views or a special imaging technique. Information technology may also meet if there has been any change in an issue over fourth dimension. Follow-up exams are often the best way to see if treatment is working or if a problem needs attending.

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What are the benefits vs. risks?

Benefits

• CCTA is non invasive. An alternative test, cardiac catheterization with a coronary angiogram, is invasive, has more complications related to the placement of a long catheter into the groin or wrist arteries extending all the way to the centre, and the motion of the catheter in the blood vessels. Invasive catheterization requires more time for the patient to recover.
• A major advantage of CT is that it is able to view bone, soft tissue and blood vessels all at the same fourth dimension. It is therefore suited to identify other reasons for your discomfort such every bit an injury to the aorta or a blood jell in the lungs.
• Unlike conventional 10-rays, CT scanning provides very detailed images of many types of tissue.
• CT examinations are fast and simple.
• CT has been shown to be cost-effective for a wide range of medical problems.
• CT is less sensitive to patient movement than MRI.
• Unlike MRI, an implanted medical device of any kind will non foreclose you from having a CT browse.
• No radiation remains in a patient'south body later on a CT exam.
• The x-rays used for CT scanning should have no immediate side effects.

Risks

• In some people with abnormal kidney function, the contrast cloth used in CT scanning may worsen kidney function.
• If dissimilarity textile leaks out from the vessel being injected and spreads nether the skin where the Iv is placed, skin impairment or damage to blood vessels and nerves, though unlikely, can upshot. If you feel whatever pain in your arm at the location of the Iv during dissimilarity fabric injection, you should immediately inform the technologist.
• In that location is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk involved with CT scanning.
• The radiations dose for this procedure varies. Come across the Radiations Dose in X-Ray and CT Exams page for more data about radiations dose.
• Women should always tell their doctor and x-ray or CT technologist if in that location is any chance they are pregnant. Meet the Prophylactic in X-ray, Interventional Radiology and Nuclear Medicine Procedures page for more information near pregnancy and ten-rays.
• Doctors do not generally recommend CT scanning for pregnant women unless medically necessary because of potential risk to the unborn baby.
• 4 contrast manufacturers betoken mothers should not breastfeed their babies for 24-48 hours after contrast material is given. However, the most recent American Higher of Radiology (ACR) Manual on Contrast Media reports that studies prove the corporeality of dissimilarity captivated past the babe during breastfeeding is extremely depression. For further information delight consult the ACR Manual on Dissimilarity Media and its references.
• The gamble of serious allergic reaction to contrast materials that contain iodine is rare, and radiology departments are well-equipped to deal with them.

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What are the limitations of coronary CTA?

A person who is very large may not fit into the opening of a conventional CT scanner. Or, they may be over the weight limit—commonly 450 pounds—for the moving tabular array.

Patients who are extremely overweight or who have abnormal heart rhythms may not be good candidates for this test because image quality may be compromised.

Unlike CCTA, which is only a diagnostic test, invasive coronary angiography can be used for both diagnosis and treatment in a single session. If a narrowing or blockage is constitute during a CCTA, it cannot exist treated at the same fourth dimension. Patients with a loftier adventure of coronary artery disease and typical symptoms might undergo coronary angiography instead of CCTA because they are more probable to need handling.

CCTA can exist difficult to read if there are many areas of old, calcified (hardened) plaque, which can be the case in older patients.

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This page was reviewed on April, 15, 2022

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