Cardiac CTA

What is it for?
A Coronary CTA is a heart-imaging test currently undergoing rapid development and evaluation for non-invasively determining whether either fatty deposits or calcium deposits have built up in the coronary arteries, which supply blood to the heart muscle. If left untreated, these areas of build-up, called plaques, can cause heart muscle disease. Heart muscle disease, in turn, can lead to fatigue, shortness of breath, chest pain and/or heart attack.

How does it work?
A Coronary CTA comes from a special type of X-ray examination. Patients undergoing a Coronary CTA scan receive an iodine-containing contrast dye as an IV solution to ensure the best images possible. The same IV in the arm may be used to give a medication to slow or stabilize the patient’s heart rate for better imaging results. During the examination x-rays pass through the body and are picked up by special detectors in the scanner. Typically, higher numbers (especially 32 or more) of these detectors result in clearer final images. For that reason, Coronary CTA often is referred to as “multi-detector” or “multi-slice” CT scanning. The information collected during the Coronary CTA examination is used to identify the coronary arteries and, if present, plaques in their walls with the creation of 3D images on a computer screen. Though the exam typically takes approximately ten minutes, the actual scan time is only 8-10 seconds.

How is Coronary CTA different from other heart tests?
One of the most common heart tests is the coronary angiogram, or cardiac catheterization. This test is more invasive and requires more patient recovery time than Coronary CTA. Patients who receive coronary angiograms must have a catheter, or small transport tube, threaded into their coronary arteries, which run along the outside of the heart. The catheter typically is inserted into a blood vessel in the upper thigh and then maneuvered up to the coronary arteries. The catheter then is used to inject the iodine dye needed for the test, which uses X-rays to record “movies” of interior of the coronary arteries.

Although Coronary CTA examinations are growing in use, coronary angiograms remain the “gold standard” for detecting coronary artery stenosis, which is a significant narrowing of an artery that could require catheter-based intervention (such as stenting) or surgery (such as bypassing). On the other hand, this new technology has consistently shown the ability to rule out significant narrowing of the major coronary arteries and can non-invasively detect “soft plaque,” or fatty matter, in their walls that has not yet hardened but that may lead to future problems without lifestyle changes or medical treatment.

What type of Coronary CTA is used at Florida Open Imaging Centers?
FOIC uses more than one type of multi-detector/multi-slice system for Coronary CTA. Currently, we are comparing the outcomes of both 40-detector and 64-detector scanners. The best uses of these scanners — and others — continue to be refined by a few leading cardiovascular centers.

What is the procedure for getting a Coronary CTA examination at Florida Open Imaging Centers? Because FOIC supports partnerships with patients and their primary physicians in its delivery of advanced non-invasive imaging, the following steps for referral for Coronary CTA are recommended:

Note: Patients and their primary physician must decide on the appropriateness of Coronary CTA, including risk factors, family history, cholesterol levels, special blood tests, high blood pressure, diabetes, cigarette smoking, obesity and level of safety [unnecessary X-ray exposure in young adults, especially women, should be avoided; histories of significant allergic reaction are best avoided; Creatinine < 2.0 mg/dL required].