Cardiac CT

The CAMC Cardiology CT Lab is located on the first floor of the CAMC Heart and Vascular Center on the campus of CAMC Memorial Hospital. The department is equipped with a Philips Brilliance iCT 256 slice CT scanner. Cardiologists that are Level III certified by the Certification Board of Cardiovascular Computed Tomography are available to review exams. All technologists are licensed by both the WV Medical Imaging Board of Examiners and The American Registry of Radiologic Technologist specializing in CT. Nursing staff are licensed by the West Virginia Board of Examiners for Registered Professional Nurses. Hours of operation are Monday through Friday, excluding holidays, 6 a.m. to 4:30 p.m. Outpatients are scheduled by calling the Cardiology CT department directly at (304) 388-8580.

What is a coronary CTA test?

A coronary computed tomography angiogram (CTA) is a heart-imaging test that helps your doctor determine whether fatty deposits or calcium deposits have built up in your coronary arteries, the arteries that supply blood flow to the heart. Using only an intravenous injection of contrast dye, the test is non-invasive and does not require placing a catheter into an artery or the heart. The computed tomography (CT) scanner can scan the entire heart during 10 heartbeats.

Why am I having this test?

Coronary CTA is used to evaluate coronary artery disease and to evaluate a patient's risk of heart attack. Since coronary CTA is able to detect small amounts of plaque that are missed on other exams, it can detect disease very early, before a patient has symptoms.

A coronary CTA can be used for:

  • Detection of sub-clinical heart disease as the basis for primary prevention
  • Pre-surgical assessment of coronary arteries
  • Evaluation of chest pain in patients with uncommon symptoms or unclear stress test results
  • Evaluation of coronary artery abnormalities
  • Checking the patency of previously placed bypass grafts

However, coronary CTA does have its limitations. For example, it is not able to image people with irregular heart rhythms. Also, very obese patients or those with heavily calcified arteries may not benefit from this exam.

How does the test work?

Using an intravenous (IV) line, iodine containing contrast dye is injected into your vein. The CT scanner, which is monitoring your pulse (heart) rate, measures when the contrast will reach the heart vessels. When the contrast is in the heart vessels, the CT scanner takes hundreds of images of your heart and then puts those back together to form a picture of your heart.

Unlike a normal snapshot, this picture can be broken down to show just the arteries, the muscles or the veins. This reconstruction will allow the cardiologist to see if you have a blocked artery that could cause you to have a heart attack.

Since the coronary CTA scans the entire heart, the test can be used to check several different problems.

What conditions should I make sure my doctor is aware of?

In advance of your exam, you should notify the radiologist or nurse if you:

  • Have had a previous reaction to iodine
  • Have any drug/food allergies
  • Have renal insufficiency
  • Have asthma or emphysema
  • Have a chance of pregnancy

What are the risks of the coronary CTA test?

A coronary CTA is a very safe procedure; however, there are some minimal risks. You could have an allergic reaction to the contrast dye used during the procedure. Also, there is

X-ray exposure, but the exposure is similar to that experienced from other heart studies, such as a nuclear medicine stress test.

Before the test

  • Blood work (BUN and Creatinine or Basic Metabolic Panel) to evaluate kidney function prior to receiving contrast must be completed within 10 days before the test on ALL outpatients.
  • Avoid any caffeinated drinks for 24 hours prior to your test, including coffee, tea, energy drinks or caffeinated sodas.
  • Avoid nicotine for 24 hours prior to test.
  • Do not use Viagra, Cialis; or any similar medications for 48 hours prior to test. They are not compatible with the medications you will receive during the test.
  • Do not eat for six hours prior to the test.

The day of the test.

  • You will then be escorted to the CT area, where you will be connected to a blood pressure machine that will take your blood pressure, and electrocardiogram (ECG) leads placed on your chest to allow us to monitor your heart rate during the test.
  • Staff will insert an IV in your arm. During the test, this IV will be used to give you medications and a contrast dye, which is used to enhance the visibility of certain tissues. You will also be given a medication called nitroglycerin (0.4 mg) that will be placed under your tongue. This medicine dilates the vessels around your heart to allow better visualization of those vessels.
  • If your heart rate is above 60 beats per minute, you will be given a beta-blocker called metoprolol to slow the rate. A slower heart rate allows us to see your heart better and obtain clearer pictures with the CT scanner.
  • In preparation for the test, the staff will instruct you on breathing techniques for the test. (For example, you will have to hold your breath for about 10 seconds.)

During the test

  • Once your heart rate is 60 beats or slower and the nitroglycerin has been placed under your tongue, you will move in and out of the CT scanner as your test is performed.
  • During the injection of the contrast dye, you may feel a warm, flushed sensation. This feeling is normal for any contrast injection.

After the test

  • The medication given to slow your heart rate, metoprolol, has been known to cause some people to feel dizzy if they stand suddenly.The dizziness is slight and happens rarely.
  • The medication given to dilate your heart vessels, nitroglycerin, has been known to cause some people to have a headache or have their heart feel like it is "racing." These symptoms are normal and should not be cause for concern.
  • Once the test is completed, you will be observed for a 30 minutes and then discharged to go home.
  • After the coronary CTA, you should drink a lot of water for the next 24 hours to help flush the contrast out of your system.