SamDawkinsConsultant Cardiologist

Cardiac CT and CT Coronary Angiography

What is CT coronary angiography?

CT coronary angiography (CTCA) is a test where x-rays and a specialised dye are used to look at the arteries that supply blood to the heart (the coronary arteries) and the structures in and around the heart, such as valves, heart chambers and the major blood vessels.

The test is commonly used for patients with chest pain, to determine whether there are any narrowings in the coronary arteries that need treatment. It is also frequently used to plan cardiac procedures, such as transcatheter aortic valve implantation (TAVI) and transcatheter mitral and tricuspid valve replacement.

Cardiac CT for planning structural heart procedures

For transcatheter valve procedures, a detailed cardiac CT is one of the most important steps in planning. It is used to measure the valve and surrounding structures precisely, choose the right device and size, check the blood vessels the device will travel through, and anticipate any difficulties before the day of the procedure. This applies to TAVI and to transcatheter mitral and tricuspid valve replacement.

What can I expect when I have a CT coronary angiogram?

We will ask you not to eat for around 4 hours before the test, and not to drink caffeinated drinks for 12 hours before the test. The test is carried out in a CT scanner which is an x-ray machine within a short tunnel. It is not as enclosed as an MRI scanner so even patients who have claustrophobia can generally manage this type of scan. In order to get clear images, the heart rate needs to be well controlled and you may need some medication (usually a beta-blocker) to slow the heart rate down.

When will I get the results?

That depends slightly on the reason for the scan. If it is for chest pain, we may be able to give you a preliminary result at the time of the scan. Please bear in mind that we carry out detailed analysis of all of the images, including the structures around the heart, so the final report usually takes a few days.

Second opinions on cardiac imaging

Dr Dawkins provides second opinions on cardiac CT scans performed elsewhere, as well as on transthoracic and transoesophageal echocardiograms. This can be helpful when a scan has raised a question about a heart valve, the coronary arteries or a structural problem, or when you have been told a procedure is not possible and would like another view.

What expertise does Dr Dawkins have in cardiac CT?

Dr Dawkins performs and reports cardiac CT himself, both for diagnosis, including CT coronary angiography for chest pain, and for planning structural heart procedures. He personally reviews the planning CT for every patient he treats with TAVI, and runs a twice-yearly TAVI CT analysis course that teaches clinicians from around the world how to carry out TAVI CT analysis.