CTA Coronary Angiogram

Indications

CTA Coronary Angiogram is commonly used to identify or assess:

  • Identify atherosclerotic disease of the coronary arteries
  •  Detect the buildup of plaque and blockages in blood vessels to determine the level or degree of coronary artery disease
  •  Coronary vein assessment (pacemaker placement)
  •  Assess post angioplasty or stent
  •  Evaluate post bypass surgery

The need for CTA coronary angiography often arises in the following situations:

The Patient is Asymptomatic (there are no problems, such as chest pain or breathlessness, but coronary artery disease needs to be considered):

  •  Family history of coronary artery disease.
  •  Persistent high triglyceride levels and other high risk factors such as smoking, diabetes, etc.
  •  ECG abnormalities on a routine health check-up.
  •  Equivocal (plus/minus) abnormalities on a routine stress test, done prior to employment, insurance or as part of a routine health check-up.
  •  Moderate to severe hypertension.

The Patient is Symptomatic (there is chest pain or breathlessness, but the physician is not convinced that there is coronary artery disease): 

  •  Atypical chest pain (right side, shoulder tip, etc).
  •  Suspected syndrome X in a pre-menopausal woman.
  •  Suspected dilated cardiomyopathy.
  •  Anomalous coronary arteries, ecstasia or aneurysms.

Other Indications: 

  •  Post-bypass
  •  Cardiac CT is an excellent tool for assessing the status of bypass grafts.
  •  Post-stent.
  •  For stents larger than 3mm in size, cardiac CT is an excellent tool for assessing in-stent lumen. For stents smaller than 2.5mm, the results are still equivocal.
  • Cardiac CT is a good tool for assessing cardiac neoplasms.

CT Coronary Angiography showing plaque as white in the center of the image of the heart.

Benefits of Noninvasive CTA

  •  Noninvasive CTA is a useful way of screening for arterial disease because it is safer and much less time-consuming than catheter angiography
  •  There is less discomfort because contrast material is injected into an arm vein rather than puncturing into a large artery in the groin

Preparing for the Procedure

The patient will be asked if they have any allergies to foods or drugs, and what medications they are currently taking. If the patient is pregnant, the technologist needs to know before the procedure. 

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