What is a CTCA?

A CT Coronary Angiography, also known as ‘CTCA’, is a non-invasive imaging study used for evaluating the coronary arteries and determining risk for future coronary events. Not only can it determine the severity of any blockages, but it can also directly visualise and identify early stages of soft plaque formation on vessel walls. It also visualises calcified plaque, which occurs in most chronic coronary artery disease.
CTCA uses computed tomography (CT) scanning to take pictures or images (angiograms) of the coronary arteries of the beating heart. These arteries supply blood to the heart muscle, and disease of these vessels (atherosclerosis) is responsible for most heart attacks.

Why might my doctor refer me for a CTCA?

A CTCA (often in conjunction with exercise stress testing) is a very good test for the evaluation of chest pain. The study can identify the presence or absence of blockages in the coronary arteries which can cause cardiac chest pain (angina), and guide further treatment. It has the highest negative predictive value of any non-invasive cardiac test for chest pain, meaning a completely normal test confidently excludes heart disease.

A CTCA, in conjunction with coronary calcium scoring, is also a very robust test for determining the risk of future cardiovascular events in asymptomatic individuals. The early identification of high risk individuals allows aggressive medical and lifestyle intervention to alter the natural history of heart disease, and reduce the risk of future events.

What is involved in a CTCA?

Your doctor typically will supply some beta blocker medication as a pre-procedure treatment to temporarily slow the heart rate. This helps with the accuracy of the study. An intravenous cannula is inserted to allow the administration of intravenous contrast to opacify the coronary vessels under X ray.

The CT scan itself is only very short in most cases, but some time needs to be factored in for preparation and post-scan observation. The vast majority of the time, the entire process takes under 2 hours.