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Chest pains, shortness of breath and fatigue may herald significant cardiac disease. Each year, about 1.1 million Americans suffer a heart attack. Approximately 500,000 of those heart attacks are fatal, and more than a third of victims do not experience any of these warnings signs. Coronary Heart Disease is the number one killer of men and women in
the U.S. Every 34 seconds a person in the U.S. dies from a heart attack. In 48% of men and 63% of women who die suddenly of coronary heart disease, there were no previous symptoms of this disease. It kills more women than breast cancer each year, and more than all other cancers combined. In fact, women are frequently under-diagnosed, and yet
carry a significant increase in cardiovascular disease such that survival rates after a heart attack lead to death in 42% of women within one year as compared to 24% in men. This is why Radiology Imaging Associates at Sterling offers a fast non-invasive outpatient Coronary CTA exam that can accurately identify your patients’ risk of heart disease.
Using the most modern ultra high speed 64-slice CT scanner, the test takes just minutes, and involves no expensive hospitalization, catheterization or exercise tests. It is a technique for evaluating the type and extent of coronary artery disease in individuals who have one or more of the following risk factors:
- Men over age 45
- Women over age 55
- High LDL Cholesterol
- Smoking
- Overweight/obesity
- Physical inactivity—Sedentary lifestyle
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- Family history of heart disease
- High blood pressure
- Low HDL cholesterol
- High stress lifestyle
- Diabetes
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Coronary CTA examinations help determine the significance of narrowing and calcium deposits in the coronary arteries, as well as a presence of fatty deposits (soft plaque) which are of significant concern. It is particularly valuable in asymptomatic patients with higher risk for coronary disease, in patients with atypical symptoms but lower risk of coronary disease, or in patients with unclear stress-test results. Unfortunately, Coronary CTA is not suitable for patients with Intra-cardiac devices such as pacemakers or defibrillators.
Radiology Imaging Associates at Sterling supports careful use of Coronary CTA for patients who have:
- Intermediate to high-risk profiles for coronary artery disease, but who do not have typical symptoms (especially unexplained chest pain, shortness of breath, or fatigue during heavy physical activity).
- Unusual symptoms for coronary artery disease (such as chest pain unrelated to physical exertion), but low to intermediate risk profiles for coronary artery disease.
- Unclear or inconclusive stress-test (exercise test) results.
Individuals who have undergone bypass surgery, angioplasty, or coronary artery atherectomy and who need their coronary arteries, bypass grafts, or stents monitored or checked for patency.
- Individuals with unexplained congestive heart failure or cardiomyopathy.
- Evaluation of congenital heart disease
- Annual follow-up of patients after heart transplant
- Exclusion of coronary artery disease in the low to intermediate risk patient—it is the best test now available with a negative predictive value approaching 100%. It can visualize early disease before it is detectable on cardiac catheterization. It may be used to clear patients for surgery instead of stress testing.
- Evaluation of wall motion and valve function
- Individuals with previous coronary artery bypass grafts that experience new symptoms or a change in symptoms.
- Individuals with suspected anomalous coronary arteries or other congenital anomalies.
- Assessment of suspected congenital anomalies of coronary circulation or great vessels.
- Assessment of the symptomatic patient when presentation is suspicious of pulmonary emboli or aortic dissection (Triple Rule-Out study)
- Assessment of mediastinal or lung parenchymal lesions, the vascularity of which is unknown or ill-defined but is critical to the diagnosis.
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The main difference in scanners is the speed with which they can complete any given type of scan. The exam takes 10-15 minutes of patient time including preparation and actual going through the scan. A simple blood test is performed at the time of the test to assess kidney function. Creatinine levels are available in 2-minutes at no additional cost to clear the patient for the study. Safe non-ionic IV contrast is administered during the procedure and the scan requires a breath hold of up to 15-seconds for a 64-slice scanner. When the contrast bolus reaches a certain threshold, the scan is started and the patient is sent through the scanner. Using the most modern generation of CT scanners, a Coronary CTA scan is comparable to a conventional catheterization procedure with respect to the radiation dosage to the patient.
In order to ensure a normal resting heart rate of 50 to 100 bpm, it is typical that an oral beta blocker is administered in order to optimize image quality and decrease blurring of the images that can occur if the heart rate is too high. Coronary CTA scans are sensitive to heart rate and heart rhythm, but the faster scanners are less compromised by arrhythmias.
In our experience, patients tolerate this procedure very well, and are pleased to have a minimally invasive test as an alternative to invasive and expensive procedures. It is not routinely required that the patient be accompanied by another adult for this exam.
A physician’s referral is needed for a Coronary CTA. Although Coronary CTA is a relatively new test, it is covered by a growing number of insurance policies. Calling in advance to get preauthorization is recommended.Our experienced staff will be glad to assist in acquiring preauthorization as well as answer any questions you may have.
Appointments can be arranged by calling (703) 450-5800. For special questions regarding Coronary CTA please call (703) 450-5800 x346.
We invite you to contact us to find out how advanced multi-slice CT can enhance the level of care for your patients.
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