What is Coronary Computed Tomography Angiogram (CCTA)?

Coronary Angiography
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A coronary computed tomography, known as CCTA or coronary CTA, is a minimally-invasive diagnostic procedure used to evaluate the arteries of the heart (the coronary arteries.)

The coronary arteries are blood vessels located on the heart. They supply blood to the heart. A buildup of a material called plaque can reduce and, in some cases, block the flow of blood to the arteries. Plaque is composed of various substances that circulate in the blood, including calcium, cholesterol or fat.

A coronary CTA, often referred to as a multi-detector or multi-slice scanner, examines the blood vessels to determine and identify abnormalities.

Reasons for a Coronary CTA

You might need a CCTA if you are at risk for coronary artery disease. The procedure is used to check for early signs of the disease in order to prevent permanent damage. The test is effective in detecting abnormalities even if you do not have symptoms, and is helpful in identifying the specific area of coronary disease if you do have symptoms.

You might also need to have a CCTA if you have any of the following:

  • Possibility of an aneurysm
  • Abnormal anatomy (shape) of the coronary arteries
  • Stress test results that are inconconclusive (indefinite)
  • Evaluating atherosclerosis of blood vessels
  • Identifying damaged blood vessels
  • Finding blood clots that may have traveled
  • Locating tumors that have blood vessels running through them/supplying them with blood
  • A coronary CTA is also performed to detect conditions such as a collapsed lung.

Why Have a Coronary CTA?

Depending on the results of a CCTA, a coronary CTA can be helpful in determining a treatment plan for the prevention of a heart attack or stroke. The test is often used to as part of the pre-operative evaluation prior to a kidney transplant.

Preparing for the Coronary CTA Procedure

To prepare for the procedure, you should wear loose, comfortable clothing to your appointment. You might be offered a gown to wear during the procedure. Metal objects that include jewelry, eyeglasses, or dentures should be removed or left at home. Hearing aids or dental work may need to be removed during the examination. You may also be asked to remove any piercings.

Depending on your heart rate and blood pressure, you may be asked to take a beta-blocker medication the night before the procedure in order to lower your heart rate, which can enhance the quality of the examination.

On the day of the examination, you will be asked to avoid diet pills and caffeinated drinks such as coffee, tea, energy drinks or soda. You will also be asked to refrain from the use of Viagra or similar medication.

What to Expect During the Coronary CTA Procedure

One you begin the exam, your technician will place electrodes on your chest. The electrodes are attached to an electrocardiograph monitor (ECG) and will display your heart’s electrical activity during the examination.

An intravenous (IV) line will be inserted into your arm. An iodine contrast dye is injected into a vein through the IV. The dye will provide clear, accurate images for review. Medication will be administered through the same intravenous to slow or stabilize the heart rate. X-rays are then taken.

You may be asked to raise or lower your arms during the examination. This will help improve the quality of the images. ayou will be lying on a table that will move through the CT scanner to take several images. You may be asked to hold their breath during the scanning process.

The results of the scans are used to create 3-D images that are analyzed to identify coronary artery disease.

Benefits of a Coronary CTA

There are several benefits of the coronary CTA procedure. A coronary CTA is not invasive and does not require the insertion of any tubes or catheters into the heart. It is also time-and cost-effective with a low risk of side effects. A coronary CTA provides views of bone, soft tissue and blood vessels. It may be able to identify other reasons for a your symptoms, including an injury to the aorta or a blood clot in the lungs. A coronary CTA can be performed if you have an implantable medical device, unlike an MRI, which cannot.

Risks of a Coronary CTA

A coronary CTA is a relatively risk-free procedure. The medication used to slow the heart rate may cause  dizziness when you stand. Therefore, you may be asked to sit up slowly before you can stand. The amount of radiation exposure is very small. The contrast dye used during the procedure may cause damage to the kidneys. If you have severe kidney disease or diabetes, you may not be able to undergo this examination. If you are pregnant or nursing, you need to notify your physician before undergoing the procedure. Other risks of a coronary CTA may include an allergic reaction to the contrast dye.

A Word From Verywell

There are a number of procedures used to evaluate your heart and brain, particularly if you have had symptoms of chest pain or if you have had TIAs.

Sometimes, more than one examination could be a good option, and it is likely that your doctor will select the right tests for you based on factors such as your medical condition, your medications, and even your convenience.

It is a good idea for you to find out what you need to do in preparation for a medical test. And the staff should be able to give you an estimate regarding when you should expect test results to be reported.

Sources:

Coronary computed tomography angiography (CCTA) and cardiac magnetic resonance (CMR) imaging in the assessment of patients presenting with chest pain suspected for acute coronary syndrome, De Filippo M, Capasso R, Ann Transl Med. 2016 Jul;4(13):255

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