What is a CT scan of the heart?
CT (Computed Tomography) dedicated to the heart is a diagnostic test that allows processing of images of anatomical sections through the common X-ray. This examination provides three-dimensional images of the heart and coronary arteries.
What is the purpose of a CT scan of the heart?
The heart CT offers visualization of the heart and coronary arteries and any presence of atherosclerosis in the arteries. In addition, a CT scan performed with a contrast agent can quantify the presence of atherosclerosis. The exam is performed in two main clinical situations:
- In primary prevention: the cardiovascular risk can be better defined by calculating the coronary Calcium-score (without contrast), while with the use of contrast it provides a unique view of the presence of coronary artery disease in a very early stage, even years before it can become symptomatic.
- In patients for various clinical reasons it is necessary to evaluate the anatomy of the coronary arteries, looking for any narrowing (stenosis) or occlusions: patients with inconclusive previous tests, with previous bypass, with chronic coronary occlusions, candidates for interventions on the heart valves, etc.
The best scenario is the negative predictive value of 100% (if there is no evidence of coronary artery disease, the coronary arteries are determined as healthy).
Standards of preparation
The examination requires the patient to fast at least six hours before the exam; however, normal hydration with water is allowed. It is necessary for the patient to undergo blood tests (creatinine) to verify the renal function and therefore, the patient’s ability to dispose of the contrast medium without problems. Any drug therapies should not be discontinued, in particular those used for high blood pressure or diabetes. The patient is also required to bring all cardiovascular information of previous tests. Patients should not wear any metal items (necklaces, rings, earrings, piercings) as they may produce alterations of the images.
Which patients can undergo the examination?
The use of the contrast medium may be contraindicated in the case of previous allergic reactions, renal insufficiency, and severe heart failure as well as in other rare conditions. In cases of doubt, please contact your physician or medical department.
Generally, the examination is approached with extra caution with women of childbearing age. Pregnant women or women with suspected pregnancies must report their condition. If breastfeeding your doctor will provide any instructions about necessary suspension of breastfeeding or whether to postpone the examination.
Is the examination painful or dangerous?
The exam is generally painless. The patient will experience only a slight noise connected to the operation of the machine. The only discomfort corresponds to the injection of the contrast medium, injected intravenously, which can cause a sensation of heat. The machine for the CT scan is an open tube and therefore it does not cause problems of anxiety in claustrophobic patients.
How does the CT scan of the heart work?
The patient lies on a bed that moves horizontally in an open tube. Prior to the exam, a drug to reduce the heart rate may be administered if it is necessary. To ensure image quality, the patient is required to remain still for the duration of the exam and to hold their breath for about 10-15 seconds. The average duration of the examination is about 15 minutes.