CT coronary angiogram (CTCA) in Perth

A CT coronary angiogram, usually shortened to CTCA, is a scan that shows the arteries supplying blood to the heart. It uses a CT scanner and an injection of contrast dye to build a detailed three-dimensional picture of the coronary arteries. It can show narrowing, plaque build-up and the general condition of the artery walls without a catheter being put into the body. eCardiology's cardiologists refer for the scan, which is performed at partner radiology practices, and go through the results with you.

What a coronary calcium score is

The scan is typically combined with a coronary calcium score. This is a short scan done without contrast that measures how much calcium has built up in the artery walls. Calcium is a marker of plaque, so the score helps estimate your risk of heart disease over the coming years. Some patients have a calcium score only; others have both the calcium score and the full angiogram.

Why a cardiologist orders a CTCA

A CTCA is commonly used to investigate chest pain or breathlessness that might be coming from the heart; to check for coronary artery disease in someone with risk factors such as high cholesterol, high blood pressure, diabetes, smoking or a family history of heart disease; to look at the arteries before some types of surgery; and to check the heart arteries when another test, such as a stress test, has given an unclear result. It is not the right test for everyone. Your cardiologist will decide whether a CTCA, a stress echocardiogram or another test suits your situation.

What happens on the day

You arrive at the radiology practice and change into a gown. A small cannula (thin plastic tube) is placed in a vein in your arm, and stickers are placed on your chest to monitor your heart rhythm during the scan. A slow, steady heart rate gives the clearest pictures, so you may be given a tablet or a small injection of a beta-blocker to slow your heart rate, and a spray under the tongue to widen the arteries. You lie on the scanner bed, the contrast dye is injected through the cannula while the scanner takes pictures, and you are asked to hold your breath for a few seconds at a time. The scan itself takes only a few seconds. The whole appointment, including preparation and a short wait afterwards, usually takes one to two hours.

How to prepare

Avoid caffeine (coffee, tea, energy drinks, cola and chocolate) before the scan, because caffeine speeds up the heart; the radiology practice will tell you how long. Take your usual medicines unless told otherwise. Tell the practice if you have kidney problems, diabetes, asthma, a known allergy to contrast dye or iodine, or if you are or could be pregnant. Follow the radiology practice's own instructions about eating and drinking before the scan.

Risks and limitations

A CTCA uses X-rays. The radiation dose from a modern scanner is low, roughly similar to the natural background radiation a person receives over a year or two, but it is not zero. Your cardiologist weighs this against the benefit of the information the scan gives. The contrast dye can occasionally cause a warm flush, a metallic taste or nausea. Allergic reactions are uncommon and serious reactions are rare. The dye passes through the kidneys, so kidney function is checked beforehand in people at risk. A CTCA may be less accurate if the heart rate cannot be slowed, if there is heavy calcium in the arteries, or in people with an irregular heart rhythm. In those situations another test may be recommended.

Results and follow-up

Dr Justin Teng, who reports cardiac CT for eCardiology, holds the highest level of accreditation from the Conjoint Committee for the Recognition of Training in CT Coronary Angiography. Results are sent to your referring doctor and discussed with you at a follow-up appointment, in person or by Telehealth.

Referral and Medicare

A CTCA needs a referral. A Medicare rebate is available when the scan is referred by one of eCardiology's cardiologists. To arrange a consultation, call (08) 9468 5578 or use the Request an appointment page.

Where the scan is done

eCardiology's rooms do not have CT scanners. The scan is performed at a partner radiology practice. Consultations to discuss the result are available in Perth CBD, Joondalup, Mandurah and Albany, and by Telehealth.

Frequently asked questions

Is a CT coronary angiogram the same as a regular angiogram?

No. A regular (invasive) angiogram involves passing a thin tube through an artery in the wrist or groin to the heart. A CTCA takes pictures from outside the body with a CT scanner. If the CTCA shows a significant narrowing, an invasive angiogram may then be recommended so that it can be treated.

Can I drive home afterwards?

Usually yes. If you were given a beta-blocker, the radiology practice may ask you to wait a short while before leaving.

Does the scan hurt?

The cannula is a small needle in the arm. The contrast injection can feel warm for a few seconds. The scan itself is painless.

How is a calcium score different?

A calcium score is a quicker scan with no contrast dye that measures calcium in the artery walls to estimate long-term risk. A CTCA looks at the inside of the arteries for narrowing. Your cardiologist will tell you which one, or both, you need.