What is the difference between coronary and CT angiography?

Question

Hello doctor,

As I was feeling tired from walking, my company doctor recommended an ECG, which showed no abnormalities. He then suggested I undergo an ECHO. The ECHO report shows the following: RWMA, trivial MR, grade I LV diastolic dysfunction, and no pericardial effusion or clot. The doctor has now advised me to undergo angiography to determine the exact issue.

Please advise.

Answer 1

Hello,

Welcome to icliniq.com.

I have reviewed your reports (attachment removed to protect patient identity). The ECG (electrocardiogram) shows RBBB (right bundle branch block), and the ECHO (echocardiogram) indicates RWMA (regional wall motion abnormality) and mild left ventricular systolic dysfunction. There is mild cardiac dysfunction, so it is recommended that you undergo coronary angiography instead of a CT (computed tomography) scan, as the ECHO shows evidence of blockages. These blockages must be addressed to prevent further decline in heart function.

Your current medications are appropriate, but it would be beneficial if you could ask your doctor to add beta-blockers like Metoprolol to improve heart function. Additionally, your blood sugar levels are poorly controlled, which has contributed significantly to the blockages. It is crucial to manage your blood sugar levels effectively. Continue with daily walking or brisk walking, and maintain a low-calorie, low-fat diet. You should also start regular medications like Aspirin and statins, and take them consistently. Overall, coronary angiography is the best course of action. If you prefer not to undergo conventional angiography, you may opt for CT coronary angiography, which, if it shows abnormalities, will still require a follow-up coronary angiography.

I hope this helps.

Please feel free to reach out if you have any questions.

Answer 2

Hello,

Welcome back to icliniq.com.

Generally, both procedures are safe, but coronary angiography is more invasive and carries a relatively higher risk than CT coronary angiography. However, it is more accurate. In your case, coronary angiography is the preferred method. If the blockages are severe and more than 80 percent, angioplasty or bypass surgery may be needed, depending on the number of blockages. If the blockages are less severe, treatment can be managed with medication.

Regards.