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Advanced ImagingAt St. Paul Heart Clinic, not only are we committed to providing our patients with comprehensive, patient centered care but our physicians are among the first in the area, often in the nation, to implement proven testing and treatment options. That’s why we’re enhancing our diagnostic imaging capabilities with the addition of the new Dual Source CT scanner. St. Paul Heart Clinic is the first independent cardiology practice in the United States – and the first site in the Twin Cities – to offer this unique technology to perform coronary CT angiography and obtain coronary calcium scores. What is “Coronary CT Angiography”?
Coronary CT angiography is a relatively new, non-invasive imaging test that combines X-rays and computer technology to detect heart disease and other vascular conditions. Coronary CT angiography is an excellent diagnostic tool. During a coronary CT angiogram, an X-ray beam will rotate around you, while special detectors measures the amount of x-ray that passes through your body. The information gathered during the scan is processed by a computer and read by a cardiologist. Coronary CT angiography is not for everyone so speak with your physician for more information. Why is Dual Source CT angiography recommended? Dual Source CT technology is the state of the art CT scanner that supersedes traditional 64-slice CT scanners, particularly in its ability to visualize the coronary arteries. The Dual Source scanner essentially combines two 64-slice scanners into one, incorporating two x-ray sources and two detectors. This advanced technology enables our cardiologists to perform coronary CT angiography faster, with improved resolution, but up to 50% less radiation than traditional 64-slice CT scanners. Because it scans much faster than traditional 64-slice CT scanners, Dual Source technology can freeze-frame nearly any beating heart, allowing our cardiologists to examine patients with rapid, irregular heart rates generally without the need to administer beta-blockers (medication to slow heart rate). In some instances, Dual Source coronary CT angiography is an alternative to traditional invasive coronary angiography. What will my procedure be like? You will be asked to change into a hospital gown. A skilled healthcare provider will start an IV in your arm, as well as attach cardiac monitoring leads to your chest. You may also be given a nitroglycerin tablet during your scan, which may give you a headache.
You will lie on a scan table that slides slowly into a large CT scanner. The CT staff will take preliminary scans to help define the area to be imaged. During this time, you will be asked to hold your breath and lie still. Once the area is defined, you will receive an injection of contrast media through the IV to “highlight” the vascular structures. As the contrast is injected, you may feel a warm flushing sensation or a metallic taste in your mouth. This is a normal occurrence and will pass quickly.
It is important that you remain very still during the procedure. You may be asked to wait a short time while the images are reviewed to determine if additional images are needed. Are there risks associated with the procedure?
There is a minimal risk from radiation exposure and a small risk of reaction to the contrast medication. The contrast agent used can adversely affect kidney function in a small number of patients.
Who needs Dual Source CT angiography? The Dual Source technology advancement is making coronary CT angiography an appropriate diagnostic test for an increasing number of patients. Technically difficult patient populations in the past (obese, pulmonary disease, arrhythmia) are now more often suitable for coronary CT angiography using Dual Source technology. In some instances, Dual Source coronary CT angiography can be an alternative to traditional invasive coronary angiography.
Common indications in clinical practice (a partial listing) for Dual Source coronary CT angiography in symptomatic patients include:
- Equivocal or uninterpretable stress tests
- Chest pain syndrome in patients unable to exercise or with an uninterpretable ECG
- Acute chest pain syndromes in patients with intermediate risk of coronary artery disease (negative ECGs and cardiac enzymes)
- Persistent angina despite a negative stress test
- Suspected coronary anomalies
- Noninvasive coronary artery and graft mapping prior to repeat cardiac surgery
- Evaluation of:
- coronary arteries in patients with new onset heart failure/LV dysfunction
- pulmonary and coronary venous anatomy for planning/follow-up of electrophysiology procedures
- bypass graft stenosis or in stent restenosis
- suspected pericardial disease and cardiac masses
- aortic aneurysm, dissection, pulmonary emboli
Dual Source coronary CT angiography is not for everyone. Your family physician and St. Paul Heart Clinic cardiologists can help determine if Dual Source coronary CT angiography is an appropriate choice for you.
In asymptomatic patients, Dual Source CT can be used as a screening tool for assessment of coronary calcification and prediction of future cardiovascular risk. Coronary calcium score is the most sensitive and specific clinical test available for early detection of coronary artery disease and is a stronger risk predictor than the Framingham score.
Does my insurance cover coronary CT angiography?
Most third-party payers still have strict guidelines and pre-authorization requirements governing reimbursement for CT angiography. Given its promise, CT angiography likely will gain broad-use approval from most insurers in due course.
Where is Dual Source CT angiography available?
St. Paul Heart Clinic is the first independent cardiology practice in the United States – and the first site in the Twin Cities – to offer Dual Source CT technology.
The St. Paul Heart Clinic Imaging Center is located in our St. Paul office within the Nasseff Specialty Center at 225 North Smith Avenue, Suite 100, a few blocks west of Xcel Energy Center. The St. Paul Heart Clinic Imaging Center provides comprehensive cardiovascular diagnostic testing including echocardiography, nuclear imaging, Dual Source coronary CT angiography, coronary calcium scoring and cardiac MR. For questions or additional information, call 651-726-7025.
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