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Anyone Hear of/ Have a CTA Heart Test
CTA Heart Scan was brought to my attention last night. Any experience/ thoughts on this test/ its advisability for Sleep Apnea patients?
Views: 82
Replies to This Discussion
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Permalink Reply by Judy on
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Yes, as a matter of fact I did. I'll have to go look thru my records now since I don't remember a thing about it - at least not until just reading your post about it.
Back atchya later. I have to go pick up the CD of my bi-level re-titration study and drop my granddaughter off at the prosthetic shop.
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A CTA is a coronary or cardiac CT angiography or scan of the heart's arteries.
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Permalink Reply by sleepycarol on
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I had one a couple of years ago.
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Permalink Reply by Mike on
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any downside to getting it (other than cost?)
sleepycarol said:I had one a couple of years ago.
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CTA = Computed Tomography Angiogram. Cleveland Clinic's website has a pretty good description of it.
How is Coronary CTA different from other heart tests?
One of the most common heart tests is the coronary angiogram, or cardiac catheterization. This test is more invasive and requires more patient recovery time than Coronary CTA. Patients who receive coronary angiograms must have a catheter, or small transport tube, threaded into their coronary arteries, which run along the outside of the heart. The catheter typically is inserted into a blood vessel in the upper thigh and then maneuvered up to the coronary arteries. The catheter then is used to inject the iodine dye needed for the test, which uses X-rays to record “movies” of interior of the coronary arteries.
Although Coronary CTA examinations are growing in use, coronary angiograms remain the “gold standard” for detecting coronary artery stenosis, which is a significant narrowing of an artery that could require catheter-based intervention (such as stenting) or surgery (such as bypassing). On the other hand, this new technology has consistently shown the ability to rule out significant narrowing of the major coronary arteries and can non-invasively detect “soft plaque,” or fatty matter, in their walls that has not yet hardened but that may lead to future problems without lifestyle changes or medical treatment
The Cleveland Clinic currently supports the careful use of Coronary CTA for patients who have:
•Intermediate to high-risk profiles for coronary artery disease, but who do not have typical symptoms (especially chest pain, shortness of breath, or fatigue during heavy physical activity.)
•Unusual symptoms for coronary artery disease (such as chest pain unrelated to physical exertion), but low to intermediate risk profiles for coronary artery disease.
•Unclear or inconclusive stress-test (treadmill test) results.
For these types of patients, Coronary CTA can provide important insights to their primary physician into the extent and nature of plaque formation with or without any narrowing of the coronary arteries. Coronary CTA also can non-invasively exclude narrowing of the arteries as the cause of chest discomfort and detect other possible causes of symptoms.
To date, Coronary CTA has not been proven as effective as the coronary angiogram in detecting disease in the smaller heart arteries that branch off the major coronary arteries. For that reason, Cleveland Clinic physicians do not consider Coronary CTA as an adequate substitute for needed coronary angiography in patients with strong evidence of narrowing of the coronary arteries. Such patients include those with a history of chest pain during heavy physical activity, a history of positive stress-test results, or a known history of coronary artery disease or heart attack. Coronary CTA also is of limited use in patients with extensive areas of old calcified, or hardened, plaque, which is often the case in older patients. Patients who are extremely overweight or who have abnormal heart rhythms also tend not to be suitable candidates for this test because imaging quality is compromised
There lots more and images too for those who are interested in knowing more.
http://my.clevelandclinic.org/heart/services/tests/radiograph/coron...
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I have periods of shortness of breath, chest discomfort, dull feeling of feeling unwell. I went to the er. My mom had heart disease. I am sort of paranoid, since my mother-in-law had a heart attack and we didn't recognize the sypmtoms until it was too late. She didn't make it to the er.
I had been to the er about a year and half previously for chest discomfort, shortness of breath, etc. At that time, the docs did a stress stress -- which I passed. I was kept overnight that time and dismissed the next day after the stress test, prescribing Pilosec for acid reflux.
When I went the second time, they decided to do a complete work up -- short of doing the aoronary angiogram. I tend to bleed like crazy when I have had surgery or dental work done. I did not want anything invasive. So it was decided that they would do the work up short of the invasive procedure.
I had a fear of the dye they use, so I expressed that to the attendant (CT person) and she watched me closely, but I didn't have any type of reaction. The stress tests, also, includes some type of contrast solution, but not sure exactly what it is. I was able to do the treadmill on the stress test.
At the time, I had really good insurance and so the vast majority of the work-up, including a three day stay in the hospital was paid. I had a $500 deductible / 80/20 coverage -- but a $1,000 cap on out of pocket expense. So I am unsure how much the various testing costs.
Was told my heart was in really good condition, with no concerns regarding function, narrowing, etc. I do have risk factors though and so that probably was the reason for the good work-up.
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Permalink Reply by susan mccord on
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I've had 4 heart caths--3 in 2005 and 1 in early 2007. I was diagnosed after the first one 10/05 with coronary artery disease (CAD)--had two LAD blockages, one of which was ~ 90+%, the other ~ 50+ %. The 90%r was stented 5 days later in my second angiogram, called an andioplasty. I take heavy-duty cardiac meds to try to control the smaller blockage as its location precludes its being stented. If it blocks up, I'll have to have bypass surgery which I'd just as soon avoid as long as possible.
The reason I had one in the first place is that my older son, at age 43, was diagnosed with CAD and nearly died during his stent placement. His LAD blockage was 99%. At 100% blockage, the patient drops dead with no resuscitation possible. He should have had a bypass, but they had no idea how badly blocked he was until they were too far into the procedure to stop, and he was too critical, to wait for a vascular surgeon.
When I got home from his surgery, I had a stress test done which indicated a problem. I was immediately referred to a cardiologist who specializes in cardiac intervention and treatment.
I seriously doubt that this is, or would be indicated as a standard screening test for apnea patients UNLESS they're having symptoms or have a remarkable stress test. It's invasive and, as such, has the potential for being dangerous if not skillfully done by a qualified coronary interventionalist.
Susan McCord
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CTA is NOT invasive. The most invasive part of the CTA is the IV set. It is "merely" a computed tomography scan. Read the Cleveland Clinic explanation of a CTA that I posted above in this thread.
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so given that it's non-invasive, but somewhat costly, the question to me is whether it should be part of a routine battery of tests for the Apnea patient.
Judy said:CTA is NOT invasive. The most invasive part of the CTA is the IV set. It is "merely" a computed tomography scan. Read the Cleveland Clinic explanation of a CTA that I posted above in this thread.
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No. I would think not. Cleveland Clinic has one of THE best cardiology departments in the country and note what THEY have to say about when a CTA is or is not warranted.
I would not expect even a doppler carotid ultrasound or abdominal ultrasound to check the abdominal aorta would be justified as a routine test for apnea patients. Both much less expensive and less risky procedures (i.e. no radiation risk).
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why do you say that? Not saying I disagree. Just want to know your reasoning.
Judy said:No. I would think not.
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Why go to the time, inconvenience and expense if there are no symptoms to justify them - except curiosity? I would expect blood tests to be the first-line of investigation. Easiest, most convenient and can offer clues if further investigation is necessary or warranted. What's much easier than a 24 hour Holter monitor and an overnight oximetry? I don't know what a 24 hour Holter runs but an overnight oximetry shouldn't run more than $35. There's also the good old doppler echocardiogram. JMO but I'm JAP, not AMP.
(Just a patient, not a medical professional)
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