Cardiac Computed Tomography Angiography (CCTA)
Welcome to the Center for Information of Cardiac Computed Tomography Angiography
Radiology Center of Bangkok Hospital Phuket, we offers a wide range of diagnostic imaging services. We offers a wide range of medical imaging such as Coronary CT Angiography, CT scan, CAT scan, MRI scan, CMR scan, Ultrasound (2D, 3D and 4D) and Mammography including interventional radiology services and sub-speciality expertise available under the one roof to meet all your radiological needs. Our center is staffed by dedicated and experienced radiographers and specialist consultant radiologists report all images and scans.
Below is the basic knowledge of Cardiac Computed Tomography Angiography, you can click on the topic to read more.
What is a coronary CTA scan?
A Coronary Computed Tomography Angiography (CTA) is a heart-imaging test that helps determine if fatty or calcium deposits have narrowed a patient’s coronary arteries. Coronary CTA is a special type of x-ray examination. Patients undergoing a coronary CTA scan receive an iodine-containing contrast material as an intravenous (IV) injection to ensure the best possible images.
What are some common uses of procedure?
Many Physicians advocate the careful use of coronary CTA for patients who have:
- Presented themselves in the emergency room with chest pain.
- suspected abnormal coronary arteries.
- low to intermediate risk for coronary artery disease, but have symptom such as chest pain with are not brought on by physical activity.
- unclear or inconclusive stress test results.
- intermediate to high-risk for coronary artery disease, but who do not have typical symptom like chest pain, shortness of breath, or fatigue during heavy physical activity.
For these types of patients, coronary CTA can provide important insights into the extent and nature of plaque formation with or without any narrowing of the coronary arteries. Coronary CTA also can exclude narrowing of the arteries as the cause of chest discomfort and detect other possible causes of symptoms.
You should wear comfortable, loose-fitting clothing to your exam. You may be given a gown to wear during the procedure.
Metal objects including jewelry, eyeglasses, dentures and hairpins may affect the CT images and should be left at home or removed prior to your exam. You may also be asked to remove hearing aids and removable dental work.
You may be asked not to eat or drink anything for 4 hours beforehand, especially if a contrast material will be used in your exam. You should inform your physician of any medications you are taking and if you have any allergies. If you have a known allergy to contrast material, or "dye," your doctor may prescribe medications to reduce the risk of an allergic reaction.
Also inform your doctor of any recent illnesses or other medical conditions, and if you have a history of heart disease, asthma, diabetes, kidney disease or thyroid problems. Any of these conditions may increase the risk of an unusual adverse effect.
On the day before and day of your exam, you may be asked to avoid:
- caffeinated drinks such as coffee, tea, energy drinks, or sodas
- diet pills
- Viagra or any similar medication. It is not compatible with the medications you will receive during the procedure
One the night before the procedure, you may be asked to take a beta blocker medication to lower your heart rate. Ask your doctor if you have questions about the instructions given to you. Women should always inform their physician and the CT technologist if there is any possibility that they are pregnant
If you are breastfeeding at the time of the exam, you should ask your radiologist how to proceed. It may help to pump breast milk ahead of time and keep it on hand for use after contrast material has cleared from your body, about 24 hours after the test.
When a contrast material is introduced to the bloodstream during the procedure, it clearly defines the blood vessels being examined by making them appear bright white.
How is the procedure performed?
You will be given a gown to wear during the procedure.
A nurse will insert an intravenous (IV) line into a vein in your arm to administer contrast material (dye) during your procedure. You may be given beta blocker medication through the same IV line or orally.
While lying on the scanning table, you may be asked to raise your arms over your head for the duration of the exam.
You may be asked to hold your breath during the scanning. Any motion, whether breathing or body movements, can lead to artifacts on the images. This is similar to the blurring seen on a photograph taken of a moving object.
When the examination is completed, you will be asked to wait until the technologist verifies that the images are of high enough quality for accurate interpretation.
Your intravenous line will be removed.
Including all preparations, the coronary CTA scan takes about 15 minutes.
What will I experience during and after the procedure?
Most CT exams are painless, fast and easy.
If an intravenous contrast material is used, you will feel a slight pin prick when the needle is inserted into your vein. You may have a warm, flushed sensation during the injection of the contrast materials
and a metallic taste in your mouth that lasts for a few minutes. Some patients may experience a sensation like they have to urinate but this subsides quickly.
You will be alone in the exam room during the CT scan. However, the technologist will be able to see, hear and speak with you at all times.
After a CT exam, you can return to your normal activities.
What are the benefits vs. risks?
- Coronary CTA is noninvasive. Coronary angiograms and cardiac catheterization are more invasive, have more complications related to the vascular access into an artery and the manipulation of a catheter, and require more patient recovery time than coronary CTA.
- A major advantage of CT is that it is able to image bone, soft tissue and blood vessels all at the same time. It is therefore suited to identify other reasons for your discomfort such as an injury to the aorta or an embolus in the lungs.
- Unlike conventional x-rays, CT scanning provides very detailed images of many types of tissue.
- CT examinations are fast and simple.
- CT has been shown to be a cost-effective imaging tool for a wide range of clinical problems.
- No radiation remains in a patient's body after a CT examination.
- X-rays used in CT scans usually have no immediate side effects.
- There is always a slight chance of cancer from excessive exposure to radiation. However, the benefit of an accurate diagnosis far outweighs the risk.
- The effective radiation dose for this procedure varies.
- CT scanning is, in general, not recommended for pregnant women unless medically necessary because of potential risk to the baby.
- Nursing mothers should wait for 24 hours after contrast material injection before resuming breast-feeding.
- The risk of serious allergic reaction to contrast materials that contain iodine is extremely rare, and radiology departments are well-equipped to deal with them.
What are the limitations of Coronary CTA?
Patients who are extremely overweight or who have abnormal heart rhythms also tend not to be suitable candidates for this test because imaging quality is compromised.
Although coronary CTA examinations are growing in use, coronary angiograms remain the preferred method 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). Unlike CTA which is only a diagnostic test, coronary angiography can provide both diagnosis and treatment in a single session. Patients with a high likelihood of coronary artery disease and typical symptoms should therefore directly undergo coronary angiography.
Coronary CTA also is of limited use in patients with extensive areas of old, calcified (hardened) plaque, which is often the case in older patients.
Know your risk for heart disease, should you be concerned?
If you have one or more of these risk factors, you should talk with your physician:
- High blood pressure
- High cholesterol
- Family history of heart disease
- High stress
- Sedentary lifestyle
- This information should not be used as a substitute to consultation from a physician. Always talk with your doctor about diagnosis and treatment information.
- The service center is Radiology Center of Bangkok Hospital Phuket.
- For more information about our medical services, please contact us at firstname.lastname@example.org