Coronary Computed Tomography Angiography (CCTA)

Coronary computed tomography angiography (CCTA) is an imaging test that looks at the blood vessels in your heart. CCTA uses powerful X-rays to produce three-dimensional images, which are used to diagnose a variety of heart conditions. CCTA is a non-invasive test that requires little preparation and no recovery time.

At Columbia Radiology, we use the most up-to-date advanced cardiac CT scanners, which produce detailed images of the heart. The images are analyzed by a radiologist who specializes in imaging of the heart.

Why do I need CCTA?

Most of the time, CCTA is used to look for and evaluate narrowed or blocked coronary arteries, which reduce the blood flow to your heart (coronary artery disease). CCTA is also used to diagnose or evaluate a variety of other heart conditions. Your doctor may order a CCTA because:

• your results from a stress test, echocardiogram, or electrocardiogram indicate that you need further testing.
• you are at risk of developing coronary artery disease.
• coronary artery disease symptoms have developed or gotten worse.
• you have an abnormal coronary artery or heart structure.
• you have another type of heart disease.

How do I prepare for the test?

Before the day of your CCTA, you will receive instructions from a healthcare provider, who will review any medications you may be taking. In addition:

• do not drink any caffeinated beverages for 12 hours before the exam.
• do not eat for four hours before the exam.
• you may be given medication before the exam by the doctor who ordered the exam.
• you may be asked not to take certain medications before the exam.
• drink plenty of water.

What will happen during the test?

When you arrive for your appointment, we will ask you to change into a gown and escort you to the exam room. First, a nurse will take your blood pressure and heart rate. If your heart rate is too high, we will ask you to take a small dose of medicine to slightly lower your heart rate. It can take up to an hour for the medicine to take effect.

Once your heart rate is in an acceptable range, a nurse or technologist will insert an intravenous (IV) line into your arm or hand. This is to allow for the administration of contrast dye into the veins during the exam. Next, the nurse or technician will attach small sticky patches to your chest. These are electrodes which record your heart rate during the test.

We will then position you on the CT table, lying on your back. The nurse may give you a small pill to place under your tongue to dissolve. This medication will help us better see the arteries of your heart.

The table slides into a donut-shaped scanner. The CT technologist will leave the room to perform the scan but will be able to see, hear, and speak with you at all times. The scanner may make slight humming and clicking sounds as it takes the pictures.

During the scan, the technologist will inject a contrast dye into the IV that was placed earlier. While the contrast goes in to the IV, you may feel a warm, flushed sensation and may have a mild, unpleasant taste in your mouth for a few minutes. The technologist will instruct you to hold very still and hold your breath during the scan. Any type of movement during a CT scan will make the images look blurry and may cause the scan to have to be repeated. 

The entire process can take up to one hour, with the scan itself taking just a few minutes.

Are there any risks?

CT exams use higher radiation doses than conventional X-rays because the CT image is reconstructed from many individual X-ray projections. If the exam is medically necessary, the risk is quite small compared to the benefit of an accurate diagnosis or intervention. A few people may have a mild allergic reaction to the intravenous contrast dye. Severe allergic reactions are quite uncommon, and we are well-equipped to deal with them. 

After the test

You can immediately resume your normal activities after the test. Drink plenty of water to help flush the contrast dye from your body.

A radiologist who specializes in imaging of the heart will analyze the CCTA images and communicate the results to the doctor who requested the exam. Your doctor will then discuss the results with you. If your results suggest that you have or are at risk of heart disease, you and your doctor can discuss treatment options. Your doctor may also request additional analysis of the scan with fractional flow reserve CT (FFR-CT), which does not require any further testing or imaging.