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Cardiac Computed Tomography - Uses, Procedure, Advantages, and Risks

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A cardiac-computerized tomography (CT) scan is a diagnostic imaging procedure that helps diagnose conditions of the heart and its associated structures.

Medically reviewed by

Dr. Muhammad Zohaib Siddiq

Published At January 25, 2023
Reviewed AtJanuary 25, 2023

Introduction:

Cardiac catheterization, or a traditional angiogram, for years, has been a gold standard test for assessing the health of the human heart. But now, with remarkable progress and advancement in technology in the last few decades, cutting-edge technology has made it easier to assess the health of a human heart with the invention of cardiac computed tomography (CT). In essence, it is a short and painless procedure that allows looking at a 3D construction of the heart.

What Is a Cardiac Computed Tomography (CT)?

A cardiac computed tomography (CT) is a non-invasive diagnostic imaging procedure that shows detailed images of the heart and its associated structures, such as blood vessels, valves, etc. It gives more comprehensive images when compared to those of traditional angiograms. At times, doctors may advise for a ‘contrast cardiac computed tomography (CT)’ - it involves the use of a special dye (also known as contrast) injected and helps amplify the images.

How Different Is It From a Coronary Computed Tomography (CT) Angiography?

The terms coronary computed tomography (CT) angiography and coronary angiogram refer to cardiac or heart computed tomography (CT) scans and are often used interchangeably. It is also known as a coronary calcium scan when it is used to assess the levels of calcium build-up in the heart.

How Different Is It From a Traditional Coronary Angiogram?

Both of them are similar regarding their purpose, but their procedures majorly differentiate them. A traditional coronary angiogram is an invasive procedure that involves passing a thin, flexible tube (called a catheter) into the blood vessels (arteries). A computed tomography (CT) angiogram is much simpler and gives more detailed images using a giant doughnut-shaped computed tomography (CT) scanner. It uses X-ray beams from multiple angles and then composes the final image.

Is It a Time Cumbersome Procedure?

It takes about ten to fifteen minutes for the scan to happen, but the entire procedure, from start to end, can take up to an hour, including preliminary vitals checks and preparation for the process.

What Does the Procedure Look Like?

  • It is a fairly simple process and does not require hospitalization due to its non-invasive nature.

  • It begins with the physician informing the patient prior that they should avoid having any meals at least four hours before the procedure.

  • The patient should avoid caffeine before the procedure since it can lead to inconsistent images due to an elevated heart rate.

  • After all preliminary checks are done, the patient is taken to a CT room and asked to lie on a cushioned table.

  • Small patches are attached to the patient’s body (called) electrodes which help monitor the patient’s heart rate throughout the procedure.

  • In the case of a contrast cardiac computed tomography (CT), the contrast is injected into the patient.

  • Once the patient is positioned well, the table moves into a hollow-circular machine, and scans are made using a huge doughnut-shaped scanner.

Is There Any Downtime With This Procedure?

No, this procedure has no downtime, and the patient can resume their normal life instantly. In the case of a contrast cardiac CT, the patient should drink plenty of fluids to flush the contrast dye out of the system.

When Does a Doctor Advice for a Cardiac CT?

If an individual has the following symptoms, the doctor may advise a cardiac computed tomography (CT).

  • Arrhythmias (irregular heartbeat).

  • Breathing difficulties.

  • Sudden excessive tightness or pain in the chest (it can feel as if someone is applying a lot of pressure on the chest).

  • Discomfort extends to the arms, back, neck, left shoulder, jaws, teeth, and occasionally to the upper part of the stomach.

  • Heartburn.

  • Dizziness.

  • Nausea.

What Are the Uses of a Cardiac Computed Tomography(CT)?

Cardiac computed tomography (CT) has several applications ranging from early detection of an anomaly, diagnosis of an underlying condition, and assistance during surgeries. A few of its clinical applications are listed below:

  • Detection of anomalies in blood vessels.

  • Atherosclerosis (a condition characterized by blockages in blood vessels because of plaque deposition in the inner surfaces of the vessels). These blockages can lead to heart attacks.

  • Coronary artery disease is a condition in which atherosclerosis occurs in coronary blood vessels (in other words, there is a blockage in arteries that supply to the heart muscles).

  • To detect congenital heart disease, a traditional angiogram has been one of the primary methods of investigation. Still, since the advent of cardiac computed tomography (CT), the diagnosis and management of congenital heart diseases in children and adults have revolutionized.

  • Aids in visualization during coronary artery bypass grafts.

  • It is not only limited to coronary vasculature but can also yield information on other causes of chest pain, like aortic dissection or pericardial disease.

  • To examine post-myocardial implications.

  • To identify and locate aneurysms.

  • Detection of injuries to blood vessels of the heart and chest following trauma.

  • Visualizations of vessels that feed into tumors before procedures like chemoembolization or selective internal radiation therapy.

What Are the Advantages of Cardiac Computed Tomography (CT)?

  • It is faster than a traditional angiogram.

  • It has fewer complications since it is a non-invasive procedure.

  • It gives more precise anatomical details.

What Are the Risks Associated With Cardiac Computed Tomography (CT)?

  • Allergic reactions to the contrast at the site of injection. The site may be red or temporarily itchy.

  • Patients with prior history of kidney disease can have flare-ups.

Conclusion:

All imaging tests are designed to help assess an individual’s health, but each test has its limitations. The advantages of cardiac computed tomography(CT) outweigh its limitations and are widely used in medicine today. There are also certain scenarios wherein a traditional computed tomography (CT) angiogram works best. For instance, in the case of a severely calcified artery, the diagnostic accuracy increases when a traditional computed tomography (CT) angiogram is used because of improved spatial resolution. In the past, physicians did stress tests to diagnose damaged or blocked blood vessels, and only those blood vessels responded to the severely damaged test. (70 percent or more). Today, with the help of a cardiac computed tomography (CT) scan, physicians can identify diseases at a very early stage and make timely interventions.

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Dr. Muhammad Zohaib Siddiq
Dr. Muhammad Zohaib Siddiq

Cardiology

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