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How is Cardiac CT different from other heart tests?

One of the most common heart tests is the invasive coronary angiogram (ICA), or cardiac catheterisation. This test is more invasive and requires a longer patient recovery time than Cardiac CT. An ICA involves having a small plastic tube (cathether) threaded via an artery in the groin and passed into the coronary arteries, through which x-ray dye is injected and, using X-ray imaging, “movies” of the arteries are obtained to assess the inside of the coronaries. It is still considered to be the gold standard for detecting significant coronary artery narrowing prior to intervention such as stent placement or bypass surgery. It is usually performed to confirm marked abnormalities detected on cardiac CT or as a first line investigation.

Nuclear Medicine studies, such as sestamibi and thallium studies give an indication as to whether there is a reduction in blood flow to the heart muscle, particularly when the heart is stressed (eg. chemically with an injection or with exercise). These tests do not provide precise information as to where the blockage in the artery is located. They can however provide information with respect to significance of a narrowing of an artery found on CTCA. CTCA, on the other hand, can also be used to clarify an apparent nuclear medicine abnormality when the suspicion of significant coronary artery disease is low, without having to resort to ICA. Nuclear medicine studies involve exposure to radiation, often at a higher level than cardiac CT.

Stress Cardiac Echography refers to an ultrasound examination of the heart performed at rest and following exercise. In addition to assessing heart valves, this test provides information regarding reduced function following exercise, as an indicator of significant narrowing in a coronary artery (not dissimilar to nuclear medicine studies). Echography does not involve radiation but is also not able to depict the precise level of arterial blockage.

Often a number of the above tests are required to obtain a comprehensive assessment of coronary artery disease. However, a normal cardiac CT frequently make these other tests unnecessary.

 

Preparing for, and having a Cardiac CT

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