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Coronary CT angiography

What is the purpose of this examination?
The examination is aimed at non-invasively assessing the coronary arteries that supply the heart muscle. Using this examination, atherosclerosis involving the coronary arteries can be detected with great accuracy, even at a very early stage. In case of chest pain, the possible cause of vascular stenosis due to coronary artery disease can be ruled out.

What are the preparations needed?
A basic condition of the examination is that the patient have regular heartbeats with a relatively low heart rate at rest (sinus rhythm, 50 to 60 beats per minute). If required, a 30-to-60-minute premedication is administered before the examination to achieve this. Before the examination, 4 hours of fasting is required, but water consumption is allowed and recommended. For CT angiography, administration of a contrast agent is required in all cases; certain anti-diabetic medications need to be interrupted as instructed – the treating physician should always be consulted about these. Other medications taken regularly can be taken by the patient before the examination. After the examination, a short observation period of 20 to 30 minutes can be expected as a precaution.

How is the coronary CT angiography performed?
In the CT room, plain and intravenous contrast-enhanced series are acquired during breath hold, with ECG synchronisation.

When is the examination contraindicated?
If the patient is known to have dysrhythmia, or his/her heart rate is not optimal despite the premedication, motion artefacts may occur on our images, which highly limits their evaluation. If the patient has a certain conduction disorder (sick sinus syndrome, atrioventricular conduction disease), hypotension, or severe COPD, it may preclude premedication, and therefore the optimal heart rate cannot be achieved in these cases, and images of only limited diagnostic value can be expected. In such cases, therefore, coronary CT angiography is not the appropriate examination method. In case of evidence of contrast agent hypersensitivity, and in patients with significantly reduced renal function (eGFR lower than 30 mL/min/1.73 m2), a contrast-enhanced scan must not be performed.

Recommendation by a cardiologist is always required for the examination.