Role of CT angiography for detection of coronary atherosclerosis

Abstract

As laparoscopic surgery is replacing open surgery, similarly computed tomography angiography is replacing invasive conventional cardiac angiography. In the last century, marvelous efforts in research have improved strategies for cure, diagnosis and prevention of fatal human diseases; however, coronary artery disease, as the most prevalent cause of mortality and morbidity in the world, has remained a great challenge. Due to advancements in technology and research, it has become more simple and robust to diagnose and treat coronary artery disease (CAD) with minimal or no intervention, promising to not only diagnosis at an early stage but potential prevention altogether. While most with obvious CAD can be diagnosed easily and quickly with ECG, those identified as ‘low risk’ require more extensive testing to diagnose or rule out CAD. For example in emergency departments, low-risk patients with chest pain are diagnosed solely depending on history, ECG and blood testing for biomarkers. This approach has resulted in either delayed or miss-diagnosis of Acute coronary syndrome. To prevent this, many emergency departments now use protocols for low-risk heart patients that include cardiac stress tests and/or CT heart imaging. This review provides an overview of the current literature on the value of Computed tomography angiography and discusses how prognostic information obtained with Computed tomography angiography can be used to further integrate the technique into clinical practice.

Keywords::

• calcium score by CT scan
• cardiac CT scan
• coronary atherosclerosis
• CT angiography

Financial & competing interests disclosure

MJ Budoff is a consultant for GE Healthcare. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

No writing assistance was utilized in the production of this manuscript.

Key issues

• Computed tomography angiography (CTA) has already a place of importance in the emergency room.

• Now there is less fear of radiation as advanced technology has reduced the scan time.

• Cardiac CTA is a robust and accurate method for assessment of graft patency and detection of relevant extracardiac pathologies in a nonselected patient population after coronary artery bypass grafting surgery in routine as well as emergency clinical settings.

• Besides predicting coronary artery disease in low-risk patients, CTA also has implications in symptomatic and posttreatment patients.

• Functional assessment of myocardium and valve by CTA.

Notes