CT angiography, also known as coronary computed tomography angiography (CCTA), is a form of imaging that examines the coronary arteries to detect any plaque buildup. An artery’s inner surface is coated with plaque, a collection of fat, cholesterol, and calcium substances.

Blood flow can be reduced or completely blocked by plaque buildup, which can be accumulated over time. During CCTA scans, intravenous (IV) injections of contrast material containing iodine are administered to patients so they can see the heart’s blood vessels as clearly as possible.

CT or CAT scans are diagnostic medical imaging tests that utilize computed tomography technology. CT scan technology is used for image reformatting as well as three-dimensional images. Multi-image or multi-picture x-rays are also produced. Depending on your doctor’s preference, your photos can be reviewed on a computer monitor, printed on film or 3D printer, or transferred to a CD or DVD.

Traditional x-rays do not provide the same detail as CT images of internal organs, bones, soft tissue, and blood vessels.

Why is CCTA needed?

Physicians recommended CCTA for the following patients:

  • It is suitable for individuals with unusual coronary artery disease symptoms or to clarify findings from a stress test.
  • Patient with abnormally shaped coronary arteries.
  • Patients with typical chest pain are considered low to intermediate risks.
  • It is also appropriate for patients who have previously experienced a cardiac attack or undergone coronary artery bypass.
  • Patients have uncertain or inconclusive stress-test results.
  • An increase in stress symptoms after a standard stress test.

CCTA can provide vital information about plaque presence and extent in the coronary arteries in patients with indications/symptoms mentioned above. Aside from detecting narrowing of the coronary arteries that can cause chest discomfort, it can also view other possible causes, such as collapsed lungs, blood clots in the veins leading to the lungs, or aortic pathologies. A radiologist who would perform the test, in consultation with your primary care physician or cardiac specialist, will decide if CCTA is appropriate for you or not.

Preparations for test

For CT angiography, the doctor should provide complete guidelines and instructions to the patient about the following pre-test, during the test, and post-test precautions and requirements.

1. Food and medications

Before the test, an individual should avoid eating anything for approximately four hours. It is okay to drink water, but if a patient takes a caffeinated drink 12 hours before the test, there may be difficulties getting clear images of the heart due to a the fluctuation of heart rate.

An individual should inform the doctor about the medications currently using as they may be asked to stop taking a medication temporarily or avoid it altogether before the test. Moreover, if an individual is allergic to contrast dye, the doctor may ask to take steroids 12 hours before the procedure to decrease the possibility of a reaction.

2. Personal belongings and clothing

For a test, the patient is required to wear the hospital gown, take off all clothing above the waist, remove jewelry and glasses.

What you can expect

Radiology departments and outpatient imaging facilitators usually perform CT angiograms. For the test, an individual must have followed expectations regarding test procedure;

1. Before the procedure

The patient may be prescribed a beta-blocker to slow down the heart rate, giving a more detailed CT scan picture. Be sure the doctor knows that patient has ever experienced beta-blocker side effects.

Resultantly, coronary arteries may be widened (dilated) with nitroglycerin. Moreover, a CT scan may be performed with contrast, a dye that helps blood vessels appear more clearly on the x-ray. Medication might be prescribed to the patient if they are allergic to contrast material.

2. During the procedure

Patients’ hands or arms will be numbed with numbing medication, followed by an IV insertion filled with dye. In addition to the sticky patches, patients’ chests will also be covered with electrodes recording the heart rate. An imaging machine (CT scanner) slides along a long table. The doctor can also prescribe medications if the patient feels uncomfortable in closed spaces. The scanner requires you to hold your breath and remain still during the scan. Otherwise, images may appear blurry.

The technician operates the CT machine from a glass window separate from the exam room. Although the scan may only take five seconds, the whole process can take an hour.

3. Post Procedure

A patient can resume daily routine after the CT angiogram is completed. Generally, they will drive themselves back and forth from the hospital. The patient needs to drink a lot of water to cleanse the dye system.

Results:

Immediately following the test, an individual should see the CT angiogram images. During the next appointment with the doctor who requested the angiogram, doctor should discuss the CT scan results and the treatment options if the patient has or is at risk for heart disease. Even if the heart test is normal, a healthy lifestyle can help an individual keep the heart in good shape. Among these are;

  • Keep your body active: Keeping the body physically active can help individuals control diabetes, high cholesterol, and high blood pressure, ultimately reducing cardiovascular disease risk. Try running for at least 150 minutes a week, or at least 75 minutes a week of vigorous aerobic activity, with the doctor’s approval. Spread your exercise over multiple 10-minute sessions throughout the day.
  • Have healthy meals: To reduce the body weight, blood pressure, and cholesterol level, an individual must have a habit of eating fruits, vegetables, and whole grains daily.
  • Quit smoking: Atherosclerosis is associated with smoking, a significant risk factor for heart disease. It is best to quit smoking to get rid of heart issues and complications. Doctors can advise you better about how to quit smoking.
  • Maintain good health: Make sure to take your medications as directed by the doctor if you have diabetes, high blood pressure, or high cholesterol.
  • Calm your mind: Due to stress, a heart attack can be triggered by tightening (constricting) blood vessels. A patient must need a stress-management program to keep the mind calm and healthy. Moreover, exercise can also help in reducing stress.

References:

  • https://scct.org/page/WhatIsCTA retrieved on 8th December 2021.
  • https://www.mayoclinic.org/tests-procedures/ct-coronary-angiogram/about/pac-20385117 retrieved on 8th December 2021.