Indications for computed tomography of the heart and blood vessels

A diagnostic method that allows a complete assessment of the functioning of the heart muscle and coronary arteries is called cardiac CT. Scanning an organ allows you to obtain detailed layer-by-layer images in all planes and sections.

Indications for the study

Cardiac tomography is prescribed by a cardiologist if a person has certain complaints and conditions. These include:

• nagging pain felt in the subscapular region, intensifying with any movement;
• pain in the chest area not associated with injury to the bone skeleton or soft tissues in the heart area;
• periodically numbness of the little finger of the left hand or foot;
• severe shortness of breath, the causes of which remain unclear;
• prolonged increase in blood pressure;
• constantly red cheeks (the condition is not associated with skin pathologies, allergic manifestations and low/high air temperatures);
• suspected abnormal development of the heart;
• elevated blood calcium readings;
• danger of blood clots forming in the cardiac cavity;
• suffered a heart attack.

In addition, cardiac CT can be performed as a diagnostic procedure to assess the blood supply to the myocardium. The study is periodically prescribed for established angina.

When a procedure may be prohibited

The technique, like any other study, has contraindications. CT should be abandoned if:

• the patient’s body has permanent metal implants;
• the subject suffers from claustrophobia (fear of closed spaces) and hyperkinesis (inability to control body movements);
• the patient is pregnant;
• examination is necessary for a child under 14 years of age;
• a person is allergic to iodine (when performing a cardiac CT scan with contrast);
• the patient's weight exceeds 120 kg;
• there are confirmed kidney and liver diseases (when using a contrast agent);
• the patient has thyroid disease and diagnosed diabetes mellitus.

It is advisable for breastfeeding women to avoid the procedure. But if there is no other choice, then breastfeeding can be resumed after 48 hours.

Types of computed tomography of the heart

During the scanning process, X-rays are directed at the area being examined. This approach ensures obtaining high-quality images in various planes. Since the heart is constantly moving, a high-frequency X-ray sensor is used during the procedure.

Coronary angiography of the heart vessels

CT coronography (also known as cardiac angiography) is a study of the coronary arteries. The technique allows you to evaluate the bloodstreams that deliver blood to the heart. The doctor sees the condition of the coronary vessels on the monitor screen and can determine the location of the narrowing of the artery.

Cardiac CT may be recommended in the following cases:

• pain in the chest and heart, as the condition may be a symptom of coronary artery stenosis;
• prescribed drug treatment does not give the expected results;
• as preparation for heart valve replacement surgery;
• to determine the effectiveness of the bypass performed;
• with heart failure;
• chest injury.

Angiography of the coronary vessels can also be prescribed as a preparatory stage for complex operations on other organs.

Research will be contraindicated if:

• pathologies of the circulatory system;
• renal failure;
• bleeding;
• lung diseases;
• diagnosed diabetes mellitus.

The advanced age of the patient is a relative contraindication.

How to prepare for the CT coronography procedure

The preparation is quite lengthy and requires passing a number of medical examinations. As a rule, the patient is prescribed:

• clinical examination and blood biochemistry;
• kaogulogram;
• general urine analysis;
• ECG;
• Doppler ultrasound;
• chest x-ray.

Preparation also includes determining the blood group and Rh factor. Testing for HIV and hepatitis is required.

When the necessary tests are ready and the date of the study is set, you will need to prepare for the procedure itself. Simple recommendations:

• The start of tomography should be preceded by a “fasting” period: you need to eat your last meal no later than 6 pm. On the day of the study, eating and drinking is generally prohibited;
• Before the procedure, you should not take any medications, including insulin;
• Before starting the study, you must empty your bladder.

How is coronary angiography performed?

CT scan of the heart vessels is performed with the mandatory introduction of a contrast agent that enters the patient’s blood throughout the entire procedure.

Patient preparation involves inserting a catheter. Most often, the device is installed in the lumen of the femoral artery.

It is through this that a medical preparation based on iodine will constantly flow into the blood of the person being examined. The contrast very quickly reaches the coronary arteries located in the cardiac aorta.

The catheter can also be inserted into the radial artery located at the wrist.

The couch is then sent into the tomograph tunnel.

The research procedure takes no more than 20 minutes.

The development of an allergic reaction to the administered drug is indicated by problems such as:

• difficulty breathing;
• swelling of the face has developed;
• sore throat appeared;
• an attack of nausea or even vomiting;
• skin itching.

This must be reported to the staff immediately (there is two-way communication inside the tomograph).

Cost of the procedure

CT scan of the coronary arteries is a fairly common technique used in cardiology practice.

The price of the procedure depends on many factors.

This:

• level of medical institution;
• radiologist qualification;
• volume of consumables;
• type of painkillers, etc.

In a public clinic, CT coronography can be done free of charge. In other cases, the price of the study ranges from 8 to 30 thousand rubles.

Multislice computed tomography (MSCT) of the heart

Multislice tomography of the heart allows you to obtain a three-dimensional image of the organ. The procedure is recommended for diagnosing:

• pathology of heart valves;
• myocardial damage;
• defects of the heart chambers and pericardium.

The price of the examination depends on the region, in particular, in Moscow the cost of the procedure starts from 5 thousand rubles.

Screening MSCT-coronary calcium

This cardiac CT technique does not require special preparation. The scan can identify calcium plaques, determine how widespread they are and how much they interfere with normal blood flow.

The advantage of the technique is that there is no need to use a contrast agent, since calcium absorbs X-rays well.

Frequency of performing cardiac CT

In the process of computed tomography, X-rays are used, and the patient receives a certain dose of radiation in any case. Ideally, the time interval between the two procedures should be 12 months. If absolutely necessary, a CT scan can be performed again 6 months after the first examination.

• The technique allows you to diagnose the disease at the very beginning of its development.
• During the scanning process, the doctor receives a three-dimensional image of the heart, which helps in making an accurate diagnosis.
• The duration of the study does not exceed 20 minutes.

CT scan of the heart and coronary vessels makes it possible to diagnose serious diseases at the initial stage of development, saving the lives of many people.

Source: https://DiagnostLab.ru/kt/grudnaya-kletka/kt-serdtsa.html

Who needs a cardiac tomography and why?

25.11.2017

A modern and popular diagnostic measure - MRI (magnetic resonance imaging) of the heart - is widely used to visualize the coronary vessels, structures of this organ and regional soft tissues. A research instrumental procedure allows you to assess the characteristics of blood flow and the general condition of the cardiovascular system.

Using MRI, any vascular pathology can be determined, which makes it possible to make a correct diagnosis and prescribe effective treatment. Among the advantages of this technique are non-invasiveness, visualization in several planes, analysis of functions and high clarity of the resulting images.

Briefly about the structure and functions of the heart

The heart is located between the lungs, spinal column, diaphragm and sternum. By contracting, it ensures the movement of blood through the vascular system. The heart in the thoracic region is slightly shifted to the left half of the body. Its weight varies from 300 to 350 g.

The heart consists of the following parts:

• Cardiac chambers (cavities) - left, right atrium and left, right ventricle. The chambers of the heart are separated from each other by partitions.
• Arteries - right and left. They start from the upper edges of the semilunar valves, which provide only one-way blood flow.
• Valves are responsible for the flow of blood in the heart. Mitral - separates the left ventricle and atrium, tricuspid - separates the right ventricle and atrium. Pulmonary and aortic - ensure the flow of blood from the left and right ventricles of the heart.
• Veins - the pulmonary veins enter the left atrium, and the hollow veins enter the right atrium (upper and lower).
• Myocardium is the muscle tissue that makes up the bulk of the heart. It has a layered structure and a thickness of 6-11 mm.

The heart contains atypical cardiomyocytes that produce electrical impulses designed to excite, in order to contract the myocardium.

Conducting pathways provide directional conduction of electrical charge from the atria to the ventricles.

The bulk of the cellular structures in the heart area consists of working (typical) elements that provide contractile movements of the internal organ.

Among the main cardiac functions, metabolic, excretory and transport should be noted. The internal organ has homeostatic and protective capabilities. The heart provides rhythmic pumping of blood from venous to arterial structures, creating pressure.

Indications for referral for examination - symptoms

Magnetic resonance imaging of the heart is performed on the recommendation of a cardiologist in the following cases:

• Congenital heart defects.
• Dysfunctions of the cardiovascular system.
• Diagnosis of thrombosis, primary and secondary tumors.
• Exudative pericarditis and pericardial cysts.
• Cardiomyopathy, atherosclerosis or aortitis.

This diagnostic method is indispensable after a heart disease such as a heart attack, in order to assess the contractile capabilities of the internal organ.

MRI is prescribed before surgery and during the rehabilitation period after heart surgery.

You should consult a specialist if you have chest pain or blood pressure problems. Among the absolute indications for MRI, ischemic heart disease and pericarditis (inflammation) should be highlighted.

Preparing for the examination

No special preparation is required for cardiac MRI, as well as for breast MRI. Only when using contrast do you need to come to the clinic on an empty stomach. In this case, it is necessary to take blood tests.

Before the procedure, it is recommended to remove clothing that contains metal elements. It is imperative to free the body from jewelry (rings, earrings, watches, etc.). If you have metal implants, catheters or a pacemaker, you should definitely notify your doctor about this.

Progress of the procedure

An MRI of the heart is performed for 30-40 minutes. The scanning is carried out after the patient removes all metal objects and lies down on a couch that slides into the machine.

Throughout the entire procedure, you must remain motionless in order to get a clearer picture of the state of the heart and blood vessels. If necessary, fixing elements are used - belts, rollers.

When the equipment ring rotates, the patient does not feel any physical impact.

If the patient feels uncomfortable in the confined space of the tomograph, he is given general anesthesia or given sedatives. Throughout the examination, the patient can communicate with the medical staff through headphones and a headset built into the MRI machine.

Application of contrast

MRI of the heart with contrast is prescribed to obtain an accurate image of all structures of the internal organ. The essence of the technique is the preliminary introduction of a contrast agent, gadolinium, into a vein.

After this, a series of images is taken over 10 to 12 heartbeat cycles. The device allows you to visualize damaged myocardial fibers, as they receive a large amount of contrast.

Thus, a heart attack is determined.

MRI of cardiac vessels using gadolinium is prescribed for heart defects, coronary spasm, inflammation and cardiomyopathy. Using this technique, the condition of the pulmonary arteries can be determined.

Possible contraindications and restrictions

Due to the specific structure of the tomograph, not all patients can be eligible for MRI. Among the main contraindications are:

• The patient has metal implants with the exception of titanium structures.
• Panic attacks, mental disorders and claustrophobia (fear of closed spaces).
• First trimester of pregnancy.
• Obesity (when body weight exceeds acceptable limits).
• A serious condition requiring monitoring of vital processes.

Harmful effects are possible after bypass surgery, but it all depends on the type of implants used. Contrast should be administered with caution in the presence of liver and kidney failure.

The absolute indication for the use of gadolinium is pregnancy. A serious allergic reaction may occur in response to the contrast agent injected.

Interpretation of examination results

An MRI of the heart and coronary vessels will show the diseases and pathological conditions present in the body. Using this diagnostic measure, the following diagnoses can be made:

• Aortic aneurysm is an enlargement of the aorta that occurs due to pathological changes in the connecting structures, against the background of inflammation, atherosclerosis and mechanical damage.
• Dissecting aortic aneurysm is characterized by damage to the inner lining of the aorta, which is fraught with the appearance of a false opening and hematomas. Aortic dissection is dangerous due to the development of acute ischemia.
• Atherosclerosis of the aorta is a serious disease that develops when fat processes in the body are disrupted. This is fraught with the deposition of cholesterol and calcium salts and leads to the formation of plaques that clog the vascular lumens.
• Aortitis is an inflammation of individual layers or the entire thickness of the aorta. Accompanied by symptoms such as limb ischemia, fever, chills, dizziness and fainting.
• Coronary heart disease is a myocardial pathology characterized by a relative or absolute disturbance of circulatory processes in the region of the muscular layer of the heart. This occurs against the background of damage to the coronary heart arteries.
• Cardiomyopathy is damage to the heart muscle, the causes of which are unknown. Accompanied by an increase in heart size, rhythm disturbances and the development of failure.
• Pericarditis is an inflammation of the serous membrane of the heart, most often in the area of ​​the visceral layer. Develops against the background of various diseases. It is not considered as a primary pathology.
• Congenital absence of the pericardium is most often incomplete and is diagnosed only from the left heart. Accompanied by fainting, shortness of breath and chest pain. There are signs of atrial compression.
• Pulmonary embolism (PE) is a blockage of the branches and the pulmonary artery itself by blood clots that form in the area of ​​large veins of the pelvis or lower extremities.
• Heart clots - if a blood clot moves on its way to the heart, then the person experiences dizziness, suffocation, and tachycardia. There is pallor of the skin and a decrease in blood pressure. If treatment measures are not taken in time, death may occur.
• Heart tumors (myxomas, rhabdomyomas, fibroelastomas, etc.) – neoplasms arise from cardiac tissue or grow from neighboring internal organs. Accompanied by fever, chills, chest pain and shortness of breath.

Let's sum it up

If it is not possible to do an MRI of the heart for one reason or another, then you can use other diagnostic methods. This technique has much in common with ultrasound and CT (computed tomography).

Currently, not only magnetic resonance imaging, but also coronary angiography is used to diagnose the pathological processes described above.

This procedure is an X-ray contrast scan of the heart vessels.

Who needs a cardiac tomography and why Link to main publication

Source: https://diagme.ru/mrt/bryushnaya-i-grudnaya-polost/obsledovanie-serdtsa

MSCT of the coronary arteries: advantages, indications, contraindications, preparation

The work of the heart depends on the supply of oxygen to the blood. The coronary arteries are responsible for this. Any malfunctions in their work lead to dangerous diseases of the cardiovascular system and death. MSCT of the coronary arteries allows you to quickly identify pathology, most effectively determine the extent of the disease, and morphologically evaluate neoplasms.

What is

The coronary arteries are responsible for saturating the heart with oxygen. Any pathology can lead to serious illnesses and sad consequences. A special MSCT procedure is capable of identifying abnormalities in the functioning of the heart and blood vessels at an early stage and showing the extent of the disease in the most informative way. The procedure involves the use of advanced, highly sensitive equipment.

MSCT is the best way in modern cardiology to identify ischemic processes in the heart, examine all vessels and see a three-dimensional image of the organ.

An X-ray contrast study combines the introduction of a small amount of special compounds into the blood and multispiral computed tomography.

Without iodine (contrast) the result will be less accurate and without a three-layer image.

Blood circulation in the myocardium will be shown by a spiral trajectory. It occurs due to a simultaneous table and ring with detectors on the surface of the tissue. The number of sensors ranges from 64 to 256 and above. Their quantity determines the quality of the image and the accuracy of the data obtained.

What is the advantage

The MSCT procedure is performed on an outpatient basis. Patients do not need to be sedated or sedated as the examination is not painful.

The main advantages include:

• speed of examination - together with positioning the patient, the process takes only 10-15 minutes;
• the accuracy of MSCT of the coronary arteries with contrast is more than 98%;
• non-invasiveness – absence of painful methods and surgical instruments;
• building three-dimensional structures, multi-layered research, bright and understandable images for patients;
• identification of diseases and abnormalities such as: damage to the walls of the heart, embolism, circulatory disorders, myocardial damage, signs of scarring, malfunctions of valve structures, calcification of the leaflets, myocardial aneurysms, etc.;
• no age contraindications;
• The study helps determine effective treatment in a short time.

When is it prescribed?

MSCT of the coronary arteries and heart is a way to confirm or exclude vascular stenosis and myocardial dysfunction. The reason for the study is most often chest pain, shortness of breath, heart rhythm disturbances, loss of consciousness and other symptoms.

Spasms of the coronary vessels lead to the development of angina pectoris, coronary artery disease, and myocardial infarction. Improper physical activity, lack of rest and proper sleep also cause valve pathologies, small focal cardiosclerosis, and the appearance of areas of sclerosis.

Highly sensitive sensors detect, record and diagnose any abnormalities.

Possible genetic diseases - indications for research. Pathology of the arterial cardiac network is excluded or confirmed.

In case of aneurysm, rupture of the aortic wall, or thrombosis, MSCT is prescribed - angiography of blood vessels and coronary arteries. The non-invasive study has a peculiarity - vascular structures are assessed and observed along their entire length. An angiogram has similar contraindications and preparation as coronary angiography.

Contraindications for carrying out

Even the safest method of diagnosing the heart arteries, which does not have a better alternative, has some contraindications. For example, the procedure is not compatible with the radioactive iodine treatment process. Other contraindications:

Also read: Review of devices for measuring blood pressure

Preparing for the study

To exclude possible complications after the examination, it is necessary to take a test for urea and creatinine levels in the blood in advance. Patients over 65 years of age are recommended to undergo an examination to identify possible disorders of the kidneys, lungs, and heart.

CT scan of the coronary arteries of the heart does not require special preparation. But for maximum diagnostic accuracy, you should not drink strong tea, coffee, heavy food, alcoholic drinks, or smoke within 4-5 hours. You should not take medications that affect heart contractions.

To go to a specialist who performs MSCT, you should prepare all previous studies: ultrasound, CTG, MRI, previous MSCT and extracts, so that the doctor can assess the full picture of the disease over time.

How is MSCT of the coronary vessels performed?

The patient puts on a special gown and lies on his back on the tomograph table. The anesthesiologist installs a catheter on the arm. Through it, a contrast agent enters the vein. It is administered at a rate of 5 ml per minute throughout the entire procedure. Electrodes are placed on the chest and limbs. They are synchronized with heart contractions.

When the preparations are completed, the doctor instructs you to hold your breath and exhale. The procedure time depends on the number of detectors, their sensitivity and the size of the area being examined. It ranges from 1 to 5 minutes.

The iodine contrast agent may cause a metallic taste in the mouth, a slight burning sensation in the chest, and warmth. Such feelings may be intensified in the presence of allergies. But the speed of MSCT prevents these sensations from causing discomfort.

All data is recorded. At the end of the procedure, the catheter is removed and a bandage is applied to the area so that there is no scar or bruise left. The results are given out immediately. They can be on paper, on film or recorded on electronic media.

Decoding the received data

Multislice computed tomography of the heart and coronary arteries not only establishes the disease, but also its cause. An accurate three-dimensional image allows you to examine the smallest details, all branches of the organ’s vascular system. The 3D model shows “chopped off” vessels, the structures of the altered arterial wall.

The specialist makes a detailed transcript of the data obtained, talks about the causes of the pathology, and compares it with previous results, if any.

How often can you carry out

During the study, a small dose of radiation is present. Therefore, it is recommended to carry out the procedure no more than 2 times a year. But in individual cases, as prescribed by the attending physician, it is possible to use the MSCT method more frequently.

Price

Various factors influence the cost of the procedure. The price of MSCT of the coronary arteries with contrast depends on:

• region;
• number of detectors on the tomograph;
• institutions - municipal or private;
• sensitivity and novelty of equipment;
• availability of support from a cardiologist, cardiac surgeon, angiologist;
• presence or absence of contrast.

Based on these factors, the price ranges from 5 to 10 thousand rubles. and higher.

MSCT is the most effective, safe and accurate method for studying the heart vessels. It combines the advantages of MRI and ultrasound, without borrowing the disadvantages of these studies.

In a few minutes, a visual reconstruction of the main human organ shows the condition of the heart, blood vessels, and blood supply, which allows timely prevention of serious pathology, assessment of the patient’s condition and prescribing effective treatment.

Source: https://KardioPuls.ru/diagnostika/mskt-koronarnyh-arteriy/

CT scan of the heart - what is it, how is it done?

Computed tomography or CT scan of the heart is the most informative way to diagnose diseases of the cardiovascular system.

It allows you to evaluate the functioning of the organ, helps to identify hidden inflammatory processes and congenital pathologies that threaten the patient’s life.

The technique has a number of advantages, but the use of X-ray radiation requires attention and has a number of contraindications.

What is coronary angiography

Modern computed tomography techniques are used in many areas of medicine. One of the most promising areas is heart examination. Various congenital and acquired pathologies are difficult to diagnose using standard methods, but provoke dangerous complications.

This significantly reduces the time from the patient’s initial visit to the start of effective treatment.

CT coronary angiography is a special type of computed tomography that performs a comprehensive examination of the heart and the blood vessels that supply it. To carry it out, a contrast agent is necessarily used - a special drug that, when it enters the circulatory system, colors it from the inside. This allows you to examine all blocked and clotted areas and detect a cyst or tumor.

When performing coronary angiography, the doctor has the opportunity to monitor the condition of the heart during work. For this purpose, a scanning device is used - a tomograph. The basis for the unique method was standard radiography and the penetrating properties of x-ray radiation.

When the scanner operates, the rays are concentrated at one point and projected onto the heart using a ray tube. The signal is reflected to high-precision sensors located on the other side of the patient.

In this case, the capsule continuously rotates around the table with the patient, performing an examination from several projections and angles.

Cardiac CT has some differences from other types of tomography. To ensure that the information is as reliable and complete as possible, during operation the scanning tomograph takes images at certain intervals.

They coincide with the patient’s heart rhythm and are recorded by special sensors that are attached to the patient’s legs and arms.

Unlike standard tomography, the examination uses a special camera and sensors. As you know, the heart constantly beats, so it is difficult to photograph a moving organ. But modern scanners do this without distortion in a fraction of a second between two impacts: the pictures are as clear and high-quality as possible, respecting the proportions in any projection.

Indications for cardiac CT

Cardiac CT is a complex procedure that is performed only for medical reasons.
Doctors often try to make a diagnosis based on more familiar and accessible methods. Indications for scanning are the following patient complaints: burning pain behind the sternum, radiating to the scapula;

• severe shortness of breath;
• a feeling of spasm in the chest that interferes with breathing;
• surges in blood pressure that provoke tachycardia and arrhythmia;
• high levels of calcium in blood tests.

CT coronary angiography with the addition of a contrast agent is actively used for diagnosis in the following cases:

• after a heart attack to assess the condition of blood vessels and damaged walls;
• with angina pectoris;
• when signs of ischemic disease appear;
• to prepare the patient for complex operations on the heart and coronary arteries;
• after surgery to assess the condition of valves or blood flow;
• in case of damage to the coronary arteries due to trauma;
• in complex preparation for bypass surgery or organ transplantation.

The most pressing problem in recent years has become atherosclerosis of blood vessels. When the latter are blocked by blood clots, the blood circulation of the heart is disrupted, which can lead to the death of the heart muscle. With the help of CT, doctors have the opportunity to detect such changes at an early stage and restore patency without severe operations and reconstructions.

Increasingly, oncological diseases are becoming an indication for cardiac CT. In lymphoma or lung cancer, tumors entwine the aorta and coronary arteries and grow into the chambers of the heart. With the help of computer diagnostics, you can see a dangerous pathology in different projections, create a surgical plan for removal or radiation therapy with minimal risk for the patient.

Contraindications

CT scan of the heart and examination of the coronary vessels is considered a gentle diagnostic method. When performed correctly, X-rays do not exceed a dangerous dose of radiation. But there are a number of contraindications and health features that the doctor must take into account before prescribing a tomography:

• the patient’s pregnancy (there remains a risk of abnormal damage to growing cells after X-ray irradiation);
• claustrophobia (patients with this mental disorder find it difficult to remain calm and still when moving the table inside the scanner capsule).

More serious limitations arise when it is necessary to perform coronary angiography with a contrast agent. Almost all preparations that stain blood vessels and arteries contain iodine. This is dangerous for people with food allergies to this component or seafood. They may experience severe shortness of breath, laryngeal spasms, and other dangerous complications. In addition, examination is prohibited if the patient has the following diseases:

• renal failure;
• diabetes mellitus;
• hypothyroidism;
• cirrhosis or late stage hepatitis C.

In order for the cardiac CT results to be obtained without distortion, during operation of the scanner it is necessary to focus on the pulse within 65–75 beats. Therefore, this method of examination is not recommended for attacks of angina, severe arrhythmia and tachycardia. If there are no contraindications, the cardiologist may suggest a dose of beta blockers that lower the heart rate for several hours.

How to Prepare with CT Coronary Angiography

Unlike standard computed tomography, CT scanning of large coronary arteries requires some preparation. They involve the preparation and administration of a special solution, which gives a brighter contrast when passing through x-rays. The patient is recommended:

• the day before the examination, it is better to give up stimulating drinks (alcohol, coffee or tea);
• 4–6 hours before, you need to stop eating and drinking water to cleanse your blood vessels;
• The use of any drugs that can affect heart rhythm should be discussed in advance with a cardiologist.

A cardiac CT scan takes place in a medical center and does not require hospitalization.

How is CT coronary angiography performed?

Coronary angiography of the heart vessels is performed in a specially equipped room where a scanner is installed.

The patient must first change into clothes without metal parts, which can cause distortions and shadows in the pictures.

Using a dropper or pump injector, the person is injected with the required amount of contrast agent: in most cases, while the scanner is operating, a new dose is periodically given to examine different areas.

After a short preparation, the table goes inside the tomograph. A complete contrast-enhanced CT scan of the heart takes 30 to 120 minutes. During this time, the patient needs to remain still, relax and not talk: the sensors must only capture the pulse for accurate operation.

When to use contrast

The contrast agent is distributed only throughout the circulatory system, without penetrating into soft tissues and muscles. Therefore, it is recommended to use it to solve the following problems:

• measurement of blood flow speed;
• examination of the condition of coronary vessels, veins, capillaries;
• identifying areas of the heart muscle that do not receive blood after a heart attack;
• study of the vascular bed area;
• the need to identify a tumor that has its own vessels.

Even the smallest capillaries are visible on the monitor, which is why doctors use this research method during bypass surgery.

What does the examination show?

Computed tomography of the heart and blood vessels examines in layers. They are transferred to the monitor in the form of a clear three-dimensional image. The doctor has the opportunity to create a virtual model of the organ, in which any pathologies, cysts or damage are visible. Before surgery, such an image helps to develop an effective plan, take into account risks, and prepare for possible complications.

Among the results that a cardiac CT scan shows:

• injuries and wounds after damage;
• suppuration in the pericardial cavity;
• additional chords;
• benign and malignant neoplasms;
• rupture of the aorta or aneurysm;
• aortic valve diameter;
• blood clots and calcifications in blood vessels or on the walls of the heart.

Using a tomograph, the heart can be examined in conjunction with the internal organs and the mediastinal area. This is important when diagnosing oncological tumors, which, when growing, put pressure on the organ, disrupting its function and affecting the ability to pump blood throughout the body.

Types of cardiac tomography

There are several types of CT scans of blood vessels and the heart. The choice depends on the expected diagnosis, the condition of the veins and possible complications.

The patient must first undergo a series of tests, ultrasound and echocardiography, to ensure that there are no contraindications to contrast. For severe pathologies, doctors can use a combination of MRI methods and one of the CT methods.

This allows you to obtain complete information about defects, additional chords, and malignant neoplasms.

General coronary angiography

The standard technique uses only x-rays. Based on the scan results you can see:

• how effectively the installed stent or shunt functions;
• pathologies of development of valves and chambers;
• coronary artery stenosis;
• condition of the aorta.

General coronary angiography is performed in debilitated patients for whom the use of contrast in CT is not recommended.

CT coronary angiography of the heart vessels

A cardiac CT scan with contrast helps examine the large vessels that supply the heart. Often the cause of ischemia is blockage of veins with cholesterol plaques and poor circulation.

Adding contrast helps to identify closed areas and select a treatment method.

The technique is effective in searching for aortic aneurysm and arterial ruptures due to a blow, injury, or puncture due to a rib fracture.

MSCT coronary angiography

Multispiral scanning is a more advanced examination method. Using MSCT of the heart, you can determine:

• degree of circulatory impairment;
• vascular pathologies;
• the presence of calcium accumulations in the aorta.

The procedure combines the properties of radiography and magnetic resonance imaging.

Selective coronary angiography

The most effective option for diagnosing coronary heart disease. It is used before preparing for complex surgical interventions that require implantation of an expansion balloon, artificial valve, or angioplasty.

Using a high-quality three-dimensional image, specialists can “rehearse” the course of the operation and calculate the possible result.

Selective coronary angiography is part of the stenting procedure, allowing the doctor to monitor the insertion of the catheter.

CT angiography of cardiac vessels

The procedure is recommended if there is a significant increase in calcium levels in the blood. With its help, you can determine where the chemical substance accumulates and select effective treatment. Some calcifications can block blood flow and therefore require removal.

MSCT

Multispiral examination of the heart is carried out in a spiral. The scanner takes information from each side of the organ, so it shows any abnormalities, pathologies, and allows you to determine the size of any section and valve. The technique is characterized by high accuracy, absence of unpleasant sensations and a reduced dose of x-ray radiation.

Advantages of the method

The CT procedure and angiography of the coronary arteries are unique diagnostic methods.

Advantages over conventional echocardiography and ultrasound include:

• absence of pain, burning and discomfort;
• high degree of accuracy;
• low percentage of complications (no more than 1%);
• ease of implementation for the patient;
• the possibility of obtaining a primary diagnosis during scanning.

CT allows you to create a three-dimensional model of the patient’s heart, helping doctors conduct unique studies and operations without complications.

Price

Carrying out a computed tomography scan of the heart in most cases requires the use of a contrast agent for the accuracy of the result. Therefore, the cost of the examination varies from 8,000 to 25,000. The price depends on the level of the medical institution and the quality of the tomograph. The most expensive is coronary angiography with the insertion of a catheter into a vein, which reaches 30,000–50,000 rubles.

Source: https://mrtdom.ru/diagnostika-kt/kt-grudnoj-kletki/kt-serdtsa-chto-takoe-kak-delayut

Computed tomography of the heart

Modern computed tomography (CT) methods , such as this one, most effectively help identify calcifications in atherosclerosis before the development of obvious symptoms of this disease. The more coronary calcium, the more severe the coronary atherosclerosis, which increases the likelihood of significant vasoconstriction of the coronary system and increases the risk of future cardiovascular problems.

What does it show

• A heart scan with coronary calcium screening will help your doctor assess your risk of developing coronary artery disease.
• Because some forms of coronary disease, such as “soft plaque atherosclerosis,” cannot be detected with this CT scan, it is important to know that this procedure does not completely accurately predict your risk of having a life-threatening event such as a heart attack.
• The indication for coronary angiography is coronary heart disease, as well as its various complications. This examination is also prescribed in the following cases:

• assessment of patency of stents and shunts;
• searching for the cause of heart pain;

Many patients undergo cardiac CT to evaluate the possibility of stenting.

Your doctor may also order a coronary CT angiography (CTA) to directly look at the heart's arteries. CTA creates images of your coronary arteries. Currently, this procedure regularly complements CT examination of the heart.

Preparation

stop caffeine and smoking four hours before the test . CT machines use X-rays.

For your safety, exposure to radiation is kept to a minimum. But X-rays can harm fetal development, so this procedure is not recommended if you are pregnant.

Tell the technician and doctor that you:

• Pregnant
• Are you taking radiotherapy?

• You will change into a hospital gown. The nurse will measure your height, weight, and blood pressure. She may take some blood from you to check your lipid levels.
• You will lie on a special examination table.
• The technician will treat three small areas on your chest and place small electrodes on them, securing them with adhesive tape. Men may have their chests partially shaved to attach electrodes. The electrodes are connected by wires to an electrocardiograph (ECG) monitor, which plots a graph of your heart's electrical activity during the examination.
• You may also be given an injection of contrast agent to help the CT scanner visualize your coronary arteries better.
• During the examination, you will feel the table move inside the donut-shaped CT machine. The high-speed CT scanner takes many pictures in sync with your heartbeat.
• A heart and vascular radiologist will use a sophisticated computer program to analyze the images for the presence of calcifications in the coronary arteries. The absence of calcium is considered a “negative” result. But this does not exclude the presence of “soft” non-calcified plaques. If calcium is present, the computer will calculate a calcium “score” that can determine the degree of coronary artery disease.

A cardiac examination with coronary calcium screening lasts only a few minutes.

results

1. After your heart CT scan, you can go about your business and eat as usual.
2. The survey results will be summarized.

   They will contain the following information:

• Number and density of calcified plaques in coronary arteries
• Calcium indicator

Your heart CT scan results will be reviewed and summarized by a team of heart and vascular specialists, including a cardiovascular radiology specialist and a heart disease prevention specialist. This team will evaluate your calcium score and/or your CT angiogram along with other risk factor scores (risk factor score, blood pressure, blood lipids) to determine your risk level for future coronary artery disease and make lifestyle recommendations. , taking medications, or undergoing additional cardiac testing.

You and your doctor will receive a full report describing your risk assessment and recommendations for further monitoring. You can ask your doctor any questions you have about a heart examination with coronary calcium screening.

Price

The price for MSCT examination of heart vessels (MSCT coronary angiography) depends on the region where the clinic is located, for example, in Moscow such a procedure will cost approximately 18,000 rubles .

Source: https://kt-pet.info/vidy-kt/kt-serdtsa.html

Features of cardiac CT

The use of modern diagnostic equipment in the analysis of cardiovascular diseases provides doctors with the opportunity to make a diagnosis with high accuracy in order to choose the right treatment for each patient. Computed tomography, or CT, of the blood vessels and heart provides an accurate three-dimensional image of the heart muscle as well as the surrounding coronary vessels.

Computed tomography of the heart is carried out using special devices - tomographs, on which, during the active work of the cardiovascular system, a detailed image of different sections of the coronary arteries, as well as the entire heart muscle, is reproduced in one session.

This examination is safe and therefore indicated for most patients. A variety of scanning techniques helps doctors choose the appropriate way to diagnose dangerous cardiac conditions, which subsequently selects the most effective treatment method.

What is coronary angiography?

For a detailed study of the heart and blood vessels, a contrast research method called coronary angiography is used. In essence, this is a computed tomography scan of this area with contrast.

CT coronary angiography is a complex method for analyzing the condition of the area under study, the results of which can make objective, timely conclusions about the presence of pathologies.

It is prescribed by a cardiologist to obtain a detailed image of the parts of the heart, coronary vessels, and quickly diagnose such dangerous diseases as:

• heart valve dysfunction;
• pathologies of the myocardium, pericardium, cardiac chambers;
• ischemia, other arterial circulatory disorders;
• sclerosis, vascular thrombosis, other vascular lesions.

Coronary angiography is based on passing x-rays through the human body layer by layer. Depending on the tissue density, the ray flux is absorbed to a greater or lesser extent, which is recorded by special sensitive sensors, and subsequently presented in the form of step-by-step sections and a three-dimensional model of the organ under study.

The CT technique of the heart differs from similar studies of other organs. Since it is in constant motion, a high-frequency X-ray sensor is used to study it. A special camera takes part in the scanning, which is synchronized with the heart rhythm.

As a result, the pictures turn out static, and the picture on the screen is clear and motionless. The problem occurs in patients with arrhythmia, that is, an unstable frequency of contractions of the heart muscle.

Coronary angiography is performed on a CT scan with the preliminary administration of special drugs that provide increased detail of the tissues in the picture. The presented CT anatomy of the heart allows the doctor to draw conclusions about the general condition of the organ and quickly detect foci of pathologies.

Coronary angiography, or cardiac coronary angiography, must be performed under sterile conditions by a cardiologist. Before the examination, the nurse injects a special substance into the vein, with which you can better examine the condition of the walls of the vessels and the gaps inside them. On the eve of diagnosis, the patient receives from specialists a number of recommendations on how to prepare for the procedure.

Indications for cardiac CT

CT examination of the heart and coronary vessels is indicated in the presence of the following symptoms:

• periodic nagging pain under the shoulder blade;
• pain in the chest area;
• dyspnea;
• high blood pressure;
• excess calcium levels in the blood;
• post-infarction state;
• angina pectoris.

This diagnostic method is used when cardiac pathologies are suspected, helps the cardiologist to choose the appropriate surgical procedure, and makes it possible to monitor the condition of the operated heart.

Contraindications

CT scan of cardiac vessels has contraindications. It is not performed on patients with:

• renal or liver failure;
• bleeding, bleeding disorders;
• severe incurable diseases in their terminal phase;
• claustrophobia;
• allergies to iodine, seafood.

Scanning is not prescribed during pregnancy, lactation, or children under 14 years of age. Also, all types of CT examinations are not recommended for multiple myeloma, diabetes mellitus, and thyroid diseases. As a rule, the procedure is not performed on people with excess body weight (more than 200 kg). This is due to weight restrictions in the technical characteristics of the tomograph.

Before prescribing a heart scan, the doctor identifies contraindications to it.

How to prepare for CT coronary angiography?

Conventional screening tomography of the heart muscle is performed without preparation, but the patient is prepared in a special way for a contrast cardiac examination.

To obtain a three-dimensional accurate image of the tissue, a special X-ray contrast agent is injected into the vein. The patient limits food intake per day, which activates contractions of the heart muscle. The procedure itself is carried out on an empty stomach.

Sometimes the patient is prescribed sedatives to normalize the heart rhythm.

How is CT coronary angiography performed?

Conventional computed tomography and all its varieties, including cardiac CT, are performed in a specially equipped room where a CT machine is located.

Source: https://iDiagnost.ru/kt/osobennosti-provedeniya-kt-serdtsa