Cardiac CT is a minimally invasive test that can be used to directly visualize the coronary arteries (coronary CTA). It can be performed quickly, usually within 15-30 minutes. Patients with heart rates greater than 60 bpm may receive a beta-blocker. The typical patient receives ~100 cc of iodinated contrast. With our new CT scanner, radiation doses from coronary CTA are often 2-4 mSv, which is approximately the annual background radiation dose in New York. It also is 3-10x less radiation than is used at many other centers in New York.
Coronary CTA is particularly valuable in the low-to-intermediate risk patient to exclude obstructive coronary artery disease. It has a unique advantage over stress testing in that it can differentiate those patients with little or no disease from those that have substantial disease that is not yet obstructive. This has the advantage of allowing the physician to focus on treating those patients who are likely to develop coronary insufficiency sooner, and to follow less closely, from a cardiovascular standpoint, those patients who have little or no disease.
Another test that can assess for coronary atherosclerotic plaque is the coronary artery calcium score. Because this test is performed without an injection , it cannot directly assess for obstructive coronary artery disease. However, it is quite useful for estimating the amount of coronary atherosclerotic plaque and predicting future coronary events in asymptomatic patients. It provides a quantitative estimate of the amount of atherosclerotic plaque and allows a comparison to normal patients of the same age and gender.
Listed below are several of the more common indications for cardiac CT. Contact us if you have any questions.
Identifying obstructive coronary artery disease
• Chest pain possibly due to angina
• Equivocal stress test
• New onset heart failure
Identifying suspected coronary artery anomalies
Assessing a cardiac mass
Defining pulmonary artery anatomy prior to ablation
Coronary vein mapping prior to pacemaker placement
Click here to see the 2006 ACC / AHA / ACR Appropriateness Criteria for Cardiac CT