Heart CT Scans Spot Signs of Coronary Heart Disease

Alireza Maghsoudi, MD, specializes in general, nuclear and preventive cardiology. He is board certified in cardiovascular disease and nuclear cardiology as well as adult comprehensive echocardiography and cardiovascular tomography. He is co-director of Cardiac CT Screening at the Inova Heart and Vascular Institute. Read Dr. Maghsoudi’s profile.

Recently, my colleagues and I treated a retired physician who was complaining of heartburn and chest pain. He’d taken a stress test, which can indicate coronary artery disease. But that test came up negative. To get to the bottom of his troubles, we turned to cardiac CT screening.

The test showed significant amounts of plaque in his arteries, and steered us toward appropriate treatment.

Cardiac CT screening is an underused but effective tool that can help us diagnose coronary heart disease.

Cardiac CT Scans

Computed tomography scans, more commonly known as CT scans, combine multiple X-ray images to view specific parts of the body. Heart CT scans produce detailed views of the heart’s anatomy, coronary circulation and large blood vessels.

At the Inova Heart and Vascular Institute, we generally use heart CT scans in two ways:

• Calcium-Score Screening Heart Scan: This test predicts the likelihood of a person having a future cardiac event, such as a heart attack or stroke. It does so by detecting calcium deposits found in the coronary arteries. It is considered the most effective method for early detection of hardening of the arteries (atherosclerosis), even before symptoms have developed. The test takes only a few minutes and uses a very low dose of radiation.
• Coronary CT Angiography (CTA): With this test, we inject iodine dye into the blood vessels through an IV. This technique produces detailed images of the blood vessels and shows the extent of any plaque buildup inside them. If we don’t see any plaque, we can confidently conclude that the patient does not have coronary artery disease. In such cases, we can avoid sending patients for more invasive procedures, such as cardiac catheterization. If plaque is present, on the other hand, the test helps us determine the extent of the blockage so that we can consider how best to treat the patient. Since CTA tests use dye, they aren’t recommended for pregnant women or people with kidney disease. In general, though, these tests use low doses of radiation and are very safe.

Coronary CT Angiography revealed a significant blockage in the artery of a patient who had been complaining of heartburn.

Investment in Heart Health

Both calcium-score screening and CTA are safe tests that can help us spot problems early, before a serious event such as a heart attack or stroke. Early detection means we can start more aggressive treatments, such as medications to control high cholesterol.

I believe that coronary CT screening can benefit nearly anyone who has risk factors of coronary heart disease, including:

• Smoking
• High cholesterol
• High blood pressure
• Physical inactivity
• Obesity
• Diet high in saturated fat
• Diabetes
• Family history

Unfortunately, many insurance companies don’t cover these tests, so they’re not as widely used as they could be. Still, for patients with any of these risk factors, I believe the tests are valuable investments in your heart health.

If you’re interested in coronary CT screening, talk to your primary care physician or cardiologist or learn more about the diagnostic test available at the Inova Heart and Vascular Institute.