A computerized tomography (CT) coronary angiogram is a typical imaging test that takes a look at the arteries that supply your heart with blood.
Unlike traditional coronary angiograms, CT angiograms o not involve a catheter threaded through your blood vessels to your heart. Instead, a CT angiogram relies on a powerful X-ray machine to produce images of your heart and its blood vessels.
Coronary CT angiograms are non-invasive and do not require any recovery time. They are also an increasing option for individuals with a variety of heart conditions.
Both CT and traditional coronary angiograms expose you to radiation. If you have a known coronary artery disease, a traditional coronary angiogram may be a better option for you, since you can also get treatment for your coronary artery disease during that particular procedure.
2 Reasons for Procedure
Here are the most common reasons to undergo a CT coronary angiogram.
A coronary CT angiogram is a test that can be used to check your heart for a number of conditions. However, it is primarily used to check for narrowed arteries in your heart (coronary artery disease) that could explain chest pain or could put you at risk of a heart attack.
Coronary CT angiograms are sometimes used instead of traditional coronary angiograms to check for coronary artery disease. A CT angiogram may be better than a traditional angiogram for people who have only a moderate risk of coronary artery disease.
Coronary CT angiograms
Typically, when your doctor needs to check for blockages in your heart's arteries, he or she will perform a coronary angiogram. In a coronary angiogram, a catheter is inserted into an artery in your groin and threaded through your blood vessels to your heart.
Dye that's visible on X-rays is then injected through the catheter, and X-ray images of your heart are taken. Your doctor can see blockages and areas of narrowing in your heart's arteries on the images.
Because the catheter is near your heart, if blockages are found, your doctor can perform a procedure called angioplasty to open your blockages after a traditional angiogram. However, many people who have coronary angiograms don't have any blockages.
In a CT angiogram, no catheter has to be placed in your groin, and the dye that's visible on the CT scan is injected through an intravenous (IV) line that's placed in your hand or arm. X-ray images are still taken of your heart.
However, because no catheter is used, if you need treatment to improve blood flow to the heart, you'll need a separate procedure (a traditional coronary angiogram) to treat your condition.
Coronary calcium scan
A test that's similar to CT angiogram is a coronary calcium scan. This test uses a special type of computerized tomography to check for calcium in your coronary arteries, which can be a risk factor for coronary artery disease. No dye is injected during a coronary calcium scan.
Along with undergoing a CT coronary angiogram comes potential risks.
Because CT angiograms use X-rays to take images of heart, you will be exposed to some radiation during the test. The amount of radiation you will be exposed to will depend on the type of machine used.
With the most common type of X-ray machines, the radiation you are exposed to during the whole test is about the same as the average American is naturally exposed to over a period of one to five years.
The risk of you developing cancer from the radiation you will receive during a CT angiogram is not precisely known, but it is quite small. Because radiation can be harmful to an unborn child, you should not have a CT angiogram if you are pregnant.
It is also possible that you could have an allergic reaction to the dye used in the procedure. Talk to your doctor if you have concerns about having an allergic reaction.
4 Preparing for your Procedure
You doctor will give you instructions on how to prepare for your CT coronary angiogram.
You will usually be asked not to eat or drink anything for about four hours prior to your test. You can drink water, but avoid caffeinated drinks before your test, because they can speed up your heart rate. This can make it difficult for your doctor to get clear pictures of your heart.
You can drive yourself to the appointment, and you will also be able to drive yourself home or work after the test has been completed.
5 What to Expect
Here’s what you can expect during and after your CT coronary angiogram.
During the procedure
CT angiograms are usually performed in the radiology department of a hospital or an outpatient imaging facility. Just prior to beginning your scan, you will need to remove the clothing above your waist, as well as any jewelry. You will then change into a hospital gown.
Because your heart's constantly in motion while it beats, your doctor may give you a medication called a beta blocker, which will slow your heart rate. This will allow the doctor to see your heart more clearly.
Some people have side effects from beta blockers, such as shortness of breath or wheezing in some people with asthma or chronic obstructive pulmonary disease (COPD). Let your health care provider know if you've had side effects from beta blockers in the past.
Some newer CT machines can be used without slowing the heart rate down. However, when beta blockers can be used, a slowed heart rate generally produces the clearest CT images.
A technician will insert an intravenous (IV) line in your hand or arm to inject the dye that will make your heart's arteries visible on the images were taken by the CT scanner. You'll receive some numbing medication before the IV is inserted.
Although the actual scanning portion of the test takes as few as 5 seconds, it may take up to an hour for the whole process because beta blockers need time to slow your heart rate sufficiently. The technician will place some electrodes on your chest to record your heart rate throughout the exam.
When you're ready to be scanned, you'll lie on a long table that slides through a short, doughnut-like machine. During the test, an X-ray tube will move rapidly around your chest to take images of your heart from many different angles. You won't see the tube moving.
A technician will operate the machine from a room that's separated from your exam room by a glass window. There will be an intercom system the technician can use to talk to you. It's important to stay as still as possible and hold your breath during the scanning portion of the exam. Any movement can blur the X-ray images.
After the procedure
After your CT angiogram is completed, you can return to your normal daily activities. You should be able to drive yourself home or to work.
The images from your CT angiogram should be ready soon after your test. Usually, the doctor who asked you to have a CT angiogram should discuss the results of the test with you.
6 Procedure Results
Based on the results of your CT coronary angiogram, your doctor will discuss with you whether you have a heart condition that needs treatment, whether you're at risk of developing heart disease, and steps you can take to keep your heart healthy.
Treatments may vary, depending on what condition your doctor suspects you have.
Regardless of the results of your test, it's a good idea to make lifestyle changes to help protect your heart. This include:
Exercise regularly: Exercise helps you get to and maintain a healthy weight and control diabetes, elevated cholesterol and high blood pressure — all risk factors for heart disease. With your doctor's approval, aim for 30 to 60 minutes of physical activity most days of the week. Even if you can't make time for one 30- to 60-minute exercise session, you can still benefit from breaking up your activity into several 10-minute sessions.
Eat healthy foods: A heart-healthy diet based on fruits, vegetables, and whole grains — and low in saturated fat, cholesterol, and sodium — can help you control your weight, blood pressure, and cholesterol. Eating one or two servings of fish a week also is beneficial.
Stop smoking: Smoking is a major risk factor for heart disease, especially atherosclerosis. Nicotine constricts blood vessels and forces your heart to work harder, and carbon monoxide reduces oxygen in your blood and damages the lining of your blood vessels. If you smoke, quitting is the best way to reduce your risk of heart disease and its complications.
Maintain a healthy weight: Excess weight can contribute to high blood pressure, abnormal cholesterol levels and type 2 diabetes. Losing weight lessens these risks. Even a small weight loss of just 5 to 10 percent of your body weight helps reduce your risk.
Manage health conditions: If you have high blood pressure, elevated cholesterol or diabetes, be sure to take your medications as directed. Losing weight, eating healthy and exercising regularly can help control these heart disease risk factors too. Ask your doctor how often you need follow-up visits.
Manage stress effectively: Stress can cause your blood vessels to constrict, upping the odds of a heart attack. Ask your doctor about stress management programs in your area. Exercise can help reduce stress too.
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