Everything You Need to Know About Coronary CT Scan

What is a Coronary CT Scan?

Coronary CT scanning is a highly accurate radiological diagnostic examination that may involve the use of a contrast agent. It allows for precise exploration of the coronary arteries and the heart cavity, assessing the condition of the vessel walls. This tomography technique evaluates the anatomy of the coronary arteries, i.e., their role in transporting blood and oxygen to the heart. This makes it possible to detect early occlusions, stenoses, and atheromatous plaques that could significantly reduce blood flow to the heart muscle.

However, coronary scanning without a contrast agent only allows for the detection of calcified atheromatous plaque deposits.

 

What Types of Anomalies Can a Coronary CT Scan Detect?

A coronary CT scan is a valuable tool for detecting diseases or disorders affecting the coronary arteries (also called coronary artery disease), which can lead to partial or total obstruction of blood circulation to the heart. It can also detect coronary vasculitis, an inflammation of the blood vessels supplying the heart, as well as any anomaly of the initial part of the aorta and coronary arteries.

Coronary CT scanning can thus detect early and specifically the need for:

  • Angioplasty, a procedure that widens the narrowing and promotes normal blood circulation;
  • Coronary artery bypass grafting (CABG) aims to create new blood pathways to the heart in case of coronary artery obstruction, when angioplasty is impossible;

 

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When is a Coronary CT Scan Indicated?

What is a Coronary CT Scan Used For?

A coronary CT scan is a valuable aid in diagnosing vascular diseases, such as coronary artery disease and coronary vasculitis, and for detecting anatomical abnormalities of the coronary arteries.

Coronary artery disease, also known as coronary heart disease, is a vascular problem that can affect the heart. It is caused by atherosclerosis and is characterized by the presence of fatty deposits, called atheromas, on the inner wall of the coronary arteries. These atheromas can reduce the caliber of the arteries and release dangerous fragments, called emboli, that can travel to other parts of the body and obstruct small blood vessels far from their origin.

Coronary scanning also offers the possibility of detecting anatomical changes in the main aortic pathway and emboli in the pulmonary arteries, in addition to evaluating the effectiveness of coronary artery bypass grafting.

 

Who Needs a Coronary CT Scan?

Coronary CT scanning is indicated mainly in individuals:

  • At risk of heart disease, such as smokers and obese individuals, who experience symptoms such as chest pain and shortness of breath;
  • Suffering from heart failure and at risk of coronary artery disease.
  • With a potential risk for coronary diseases and ECG (electrocardiogram) showing abnormalities.
  • Who need to monitor the outcome of a heart bypass;

 

Coronary CT Scan as an Alternative to Coronary Angiography.

For a detailed analysis of the coronary arteries, coronary CT scanning is a promising alternative to coronary angiography, an invasive technique using cardiac catheterization.

 

What are the Advantages of Coronary CT Scanning?

Coronary CT scanning is a very precise examination and is more accurate than other diagnostic and clinical examinations. Using coronary CT scanning, it is now possible to obtain highly detailed images of the coronary vessels and reconstruct them in all dimensions. This allows for the creation of a precise representation of the heart in the form of a static image.

Coronary CT scanning is a crucial examination that can often avoid other more invasive and potentially risky tests, such as coronary angiography. The latter involves inserting a catheter into the femoral, radial (at the wrist), or brachial (at the elbow) artery, which is guided to the opening of a coronary artery. Injection of a contrast agent allows assessment of the coronary artery's condition and detection of any obstructions or narrowings, without requiring a more intrusive procedure.

Thanks to modern technology, the amount of X-rays needed to perform coronary CT scans is significantly reduced, a major advancement.

 

How is a Coronary CT Scan Performed?

Preparation

The very first part of the coronary CT scan procedure involves:

  • Answering a questionnaire about your medical history;
  • Removing your clothing and putting on a gown for the duration of the procedure.
  • For your safety and the safety of others during the examination, remember to remove all jewelry, such as earrings and piercings, at home before arriving.
  • Ensuring your blood pressure and body temperature are correctly measured;
  • An overview of what will happen and guidelines to follow during the examination;

During a coronary CT scan, it's essential to follow certain rules, particularly complete stillness. Indeed, the slightest body movement, even simple breathing, can compromise the success of the diagnostic procedure.

 

Patient Positioning

After preparation, the patient is placed on the sliding table, which is used to introduce and position them in the scanner. The position to adopt includes extending the arms behind the head.

 

Administration of Contrast Media

After patient positioning, it's time to administer the contrast medium. The procedure is directed by a radiologist who usually works with a qualified nurse.

For computed tomography (CT) scans, as with all others, the most frequently used contrast medium for cardiac testing is iodine-based.

There are three possible methods for administering this substance:

  • Orally (i.e., by ingestion);
  • By injection (i.e., by syringe or automatic pump);
  • By enema;

Once administered, the contrast medium needs a few minutes to distribute throughout the different anatomical areas of the human body.

 

Image Creation and Acquisition

After the time needed for the contrast agent to diffuse to the appropriate location, the following occurs:

  • Introduction of the patient into the gantry;
  • Transfer of all medical personnel to an adjacent room, which houses the control console for all equipment;
  • Starting the scanner: With this last step, the creation of images relating to the thoracic, abdominal, and pelvic regions and their acquisition in the console will begin;

Contraindications to Coronary CT Scanning

Here are the contraindications to coronary CT scanning:

  • Pregnancy;
  • Severe obesity;
  • Diabetes;
  • History of a severe allergic reaction to an iodinated contrast agent;
  • Renal failure;

It should be noted that, in its most severe forms, claustrophobia can also become a contraindication to coronary CT scanning.

 

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