Who should get a cardiac CT done!
The following are situations in which a cardiac CT is of use :

“To Rule Out Coronary Artery Disease”

The ability of cardiac CT to rule out coronary artery disease exceeds a predictive value of 99%. This means that when the study is reported to be normal, it will be normal. This makes it a more accurate test than stress-testing, stress-echocardiography, stress-thallium and stress-perfusion MRI. More importantly, the heart does not have to be stressed to get this information.

“To Rule Out Coronary Artery Disease”

“To Rule Out Coronary Artery Disease” is an issue that often arises in the following situations:

The Patient is Asymptomatic : (i.e. there are no problems, such as chest pain or breathlessness, but coronary artery disease needs to be ruled out)

  1. Family history of coronary artery disease
  2. Persistent high triglyceride levels and other high risk factors such as smoking, diabetes, etc.
  3. ECG abnormalities on a routine health check-up
  4. Equivocal (plus/minus) abnormalities on a routine stress test, done prior to employment, insurance or as part of a routine health check-up
  5. Moderate to severe hypertension
  6. Prior to non-coronary surgery in the adult population, etc

    1. a. Pre-ASD repair
      b. Pre-valvular repair
      c. Pre-tumor surgery

The Patient is Symptomatic : (i.e. there is chest pain or breathlessness, but the physician / cardiologist is not convinced that there is coronary artery disease)

  1. Atypical chest pain (right side, shoulder tip, etc.)
  2. Suspected syndrome X in a pre-menopausal lady
  3. Suspected dilated cardiomyopathy
  4. Anomalous coronary arteries, ectasia or aneurysms

Other Indications:

  • Post-bypass
  • Cardiac CT is an excellent tool for assessing the status of bypass grafts.
  • Post-stent
  • For stents larger than 3mm in size, cardiac CT is an excellent tool for assessing in-stent lumen. For stents smaller than 2.5mm, the results are still equivocal.
  • Tumors
  • Cardiac CT is a good tool for assessing cardiac neoplasms

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