CT Heart Scan  a resource for patients and physicians

  Who should have a CT heart scan? 


 

 General considerations

 Patients who are at increased risk of dying from coronary heart disease (CHD) should be considered candidates for CT coronary angiography. Identifying patients most likely to benefit from such a test is not simple, but the decision involves many of the factors listed below.

 

Patients with risk factors for heart disease

  • Male over 40 years old or female over 50 years old
  • Strong family history of coronary artery disease, especially at a young age 
  • High blood pressure (hypertension)
  • Prior history of heavy or prolonged smoking
  • High cholesterol levels
  • High level of C-reactive protein  (hs-CRP)
  • Metabolic syndrome 
  • Diabetes
  • Patients with risk factors who are about to undergo general anesthesia or major surgery 

Such factors are additive in their cumulative risk for coronary heart disease. Various algorithms exist for quantitating that risk, one of the oldest being the  Framingham Heart Study risk score.


Patients with symptoms of heart disease

  • Exertional chest pain or pressure
  • Unusual exertional breatlessness
  • Frequent palpitations
 

Patients with abnormal diagnostic tests

  • Equivocal stress test result
  • Equivocal myocardial perfusion stress test
  • Equivocal stress echocardiogram
  • Newly abnormal electrocardiogram
  • Dangerous arrhythmias on ECG
  • Unexplained decline in heart function on echocardiogram
 

Patients with known coronary artery disease

  •  Symptomatic patients with known coronary artery calcium
  • Symptomatic patients with previous stents or by-pass grafts 

     

Patients who should not have a heart scan

  • Patients with atrial fibrillation
  • Pregnant women
  • Asymptomatic patients with no risk factors for heart disease 

 

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