Cardiac CT Angiography

Coronary artery disease is one of the most common causes of morbidity and mortality in modern Western societies and results from the development of atherosclerotic plaques in the walls of the coronary arteries.Now, for its early and more accurate diagnosis, there is another valuable diagnostic tool in the 'arsenal' of doctors: CT coronary angiography, which is steadily gaining ground. CT coronary angiography is a painless, non-invasive diagnostic test for visualizing the coronary arteries. It is a method that has been used worldwide on a large scale for about a decade, mainly for screening asymptomatic patients. Asymptomatic patients with increased risk factors for coronary artery disease, with ambiguous results from other cardiological tests, or a significant family history, as well as in cases of suspected coronary artery anomalies, can benefit from CT coronary angiography. Additionally, the test is useful in pre-surgical evaluations (major surgeries, TAVI, etc.).

How is the examination performed?

After the detailed briefing of the patient and their special preparation, the examination is performed on a modern CT scanner before and after the intravenous bolus administration of iodinated contrast medium. During the examination, an X-ray source will rotate around the patient’s body, capturing multiple cross-sectional images of the cardiovascular formation. Subsequently, with the help of advanced software programs, the coronary arteries will be visualized and 3D images will be created, which are essential for a better assessment of the anatomy. Each scan of the cardiovascular formation performed on the CT scanner lasts only a few seconds. The entire process, including the examination, preparation, and patient briefing, takes no more than 30 minutes.

Advantages of CT Coronary Angiography

What are the advantages of CT coronary angiography that make it increasingly used?

CT coronary angiography is a non-invasive method, therefore it does not expose the patient to the potential risks of traditional coronary angiography, which, although very limited, do exist.

Its duration does not exceed 15 minutes.

It has a high negative predictive value, which can reach up to 100% in some cases. Thus, invasive procedures that would cause discomfort to the patient are avoided.

It can detect early lesions.

It also studies the wall of the coronary arteries, beyond the lumen, and can provide information about other cardiac structures, such as the myocardium, heart chambers, and heart valves.

It also examines other anatomical structures of the thorax, beyond the cardiac structures, such as the pericardium, aorta, and lungs, highlighting pathological findings that may require more specialized imaging.

CT coronary angiography is also useful for assessing the coronary arteries before a cardiac surgery, as well as for routine checks of stent and graft patency in patients who have undergone coronary artery bypass grafting.

The radiation exposure the patient receives through CT coronary angiography is very limited, thanks to modern CT scanners.

Who is it indicated for?

CT coronary angiography is ideal for asymptomatic patients who, however, face risk factors for the development of coronary artery disease, such as smoking, high cholesterol, hypertension, and diabetes, as well as for low- or medium-risk patients.

At the same time, it is contraindicated for pregnant women, obese individuals, and patients with atrial fibrillation.

Additionally, in cases where there are significant findings from clinical and laboratory tests, traditional coronary angiography is preferred, during which angioplasty or stent placement will likely be performed, something that cannot be done in a non-invasive procedure.