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The CT coronary angiogram (CTA) £1250

Do I need a CT coronary angiogram?

The coronary CT angiogram (CTA) is a diagnostic scan that is used to determine if any of the coronary arteries supplying blood to the heart are narrowed or becoming blocked.

You or your doctor may consider this procedure if:

You have symptoms such as chest pain which might suggest a narrowing of your heart arteries
You have had an EBCT scan or other tests that show significant coronary artery disease
You are at risk of heart disease and wish to have a definitive answer as to whether you have any ‘furring up’ of your heart arteries, including the dangerous soft cholesterol-rich plaques
Your previous coronary artery angioplasty, stent or bypass graft needs to be checked for a blockage
You need, or would like, a less invasive alternative to a conventional angiogram

CTA or conventional angiography?

A conventional angiogram involves several injections of contrast dye via a thin tube (catheter) placed directly in the heart arteries. Placing the catheter is invasive – it has to be put in position by passing it through a small incision in the groin into the main leg artery and up to the heart via the aorta. Once the procedure is finished and the catheter withdrawn, you will need to lie still for several hours with a heavy weight over the incision to minimize the risk of leakage.

In contrast, the CT angiogram (CTA) is completely non-invasive, requiring the injection of contrast dye via a needle in your arm. It is also much quicker and safer with no risk of damage to the heart or leg arteries. The fast speed and high spatial resolution of the Aquilion ONE scanner used at the ESC allows detailed imaging of all of the coronary arteries, indeed more so than is available by conventional invasive angiography. The incredible software of the Aquilion ONE also quantifies the precise extent of the vulnerable soft plaque as well as very accurately assessing the degree of any narrowing (stenosis).

The advantages of the CTA over a conventional angiogram

Conventional angiography	CT Coronary Angiography
Invasive procedure – several injections of contrast dye via a thin tube (catheter) placed directly in the heart arteries. A catheter is inserted through a small incision in the groin into the main leg artery and up into the heart	Non-invasive procedure – injection of contrast dye via a needle in your arm.
Risk of local damage or stroke;	Safer (no risk of local damage or stoke)
Slower – day case admission;	Quicker – avoids day case admission
Cost - more expensive	Cost - cheaper
Spatial resolution of 0.3mm	Comparable spatial resolution of 0.3mm
Cannot visualise soft plaque - which is most likely to rupture and cause a heart attack	Unique ability to visualise soft plaque - which is most likely to rupture and cause a heart attack
Higher radiation	Lower radiation, by 80-90%
You need to lie flat for several hours afterwards. You can usually resume normal activities after 48 hours.	You can drive and resume normal activities afterwards

Do I need to prepare for the CTA?

You will need to fast (no food for a minimum of two hours or caffeine containing drinks for twelve hours, but drink enough water) before you come to the centre for a CTA.

It may be necessary to give you a medicine (usually called a beta blocker) to slow your heart before the scan, as a low heart rate (below 65 beats a minute) improves the quality of the images. This is generally very well tolerated, unless you have asthma or other known contra-indications.

The beta blocker may be prescribed by your specialist if you have been referred by them, or it can be given at the Centre an hour before your scan, after we have checked your heart rate and blood pressure. Scanning takes about 45 minutes from start to finish. If you have had a beta blocker, we will check your blood pressure after the scan and assuming this is satisfactory, you will be free to leave immediately afterwards and resume your normal activities. Further details of the scanning procedure can be found in the Your Visit section.