FAQ's

Check Out your Heart in Few Seconds

Q What is Coronary Artery Disease (CAD)?

A Blockage in the main arteries of the heart is labeled as Coronary Artery Disease.

Q How does the blockage occur?

A Blockage in the coronary arteries occurs due to deposition of cholesterol on the surface of the arteries. This is a slow process and occurs over a period of time. Finally the deposits of cholesterol harden with further deposition of calcium within them.

Q What are the implications of blockage of the heart arteries?

A If the blockage becomes severe, then a person can start getting pain or discomfort in the chest. Others may complain of a choking sensation or pain, in the left arm. If the blockage persists or suddenly progresses, a person may develop a heart attack or MI (myocardial infarction). This can be life threatening.

Q Why does this disease occur?

A There are various documented risk factors that predispose an individual to develop CAD. These include a strong genetic predisposition (family history), long standing diabetes, hypertension (high blood pressure), smoking, altered cholesterol levels (dyslipidemia) and even stressful lifestyle. As the number of risk factors increase, so does the likelihood of developing CAD.

Q Can anything be done to prevent CAD?

A Yes, although one cannot change ones genes, the other risk factors can be avoided and a change in lifestyle can decrease the likelihood of developing CAD.

Q How does one detect the degree of blockage of the heart arteries?

A The most definite technique is to perform a coronary angiography, in which one needs hospitalization. A catheter with a wire is inserted into the thigh and advanced to the heart arteries. A dye (contrast) in then injected into the arteries to detect and quantify the blockage of these arteries. Although this test has been refined over the years, there are some Inconveniences to undergo this test. These are hospitalization, complete immobilization after the test for 4-6 hours and some rare procedure related complications.

Q Are there other techniques to detect the blockage?

A Traditionally, for those persons at risk for developing CAD, certain non-invasive (without any intervention) tests have been performed as a part of executive check ups, including stress test (treadmill), echocardiography and thallium tests. With these, one cannot see the arteries, but assume their blockage if found to be abnormal.

Q So is there a choice for someone if that person is not sure that he / she has CAD, or is at high risk, or has unusual or atypical symptoms, and does not want to undergo hospitalisation or an invasive test?

A YES, 64-slice Coronary CT Angiography is a non-invasive test that someone with high risk or unusual symptoms can get done, if there is a need to exclude the presence of CAD. With a negative predictive value of 99% (if this test is normal, then the likelihood of an abnormal coronary angiography is <1%), one can be assured that the risk factors have not yet affected the arteries, or the symptoms are due to some other cause.

Q What if the 64 slice CT angiography shows an abnormality?

A If there is varying degree of blockage to the heart arteries, depending on the degree of Blockage (mild, moderate or severe) the person would need further management. If the blockage is mild, then one would need some lifestyle changes and control of the risk factors to prevent the progression of blockage. If the CT angiography shows a more significant abnormality, a stenting procedure done during a coronary angiography or a bypass surgery can also be done. These decisions with be made with you by your cardiologists. A person can therefore, prevent a serious event from occurring due to the blockage.

Q Is there any additional information that CT angiography gives more than catheter angiography?

A The CT can show the wall of the arteries and tell you if the narrowing is due to calcification or soft plaques (which are more dangerous) It can also give some functional information including the ejection fraction of the heart.

Q What are the other uses for 64 slice CT Angiography?

A It can be used to follow up patients who have had a bypass surgery to see if the graft vessels are open or not. It can also be used to see if some types of stents are patent or not, especially if the symptoms recur.

Q What are the risks?

A Besides the rare risk of allergy to the dye (contrast) which is also equally there with coronary angiography, there is no additional risk to get this test done. You will be asked whether you have had any allergy or bronchial asthma in the past. With the use of safer dyes (Non-Ionic contrast), the risk of allergy is even lower. There is also an increased .risk of radiation as compared to other X-ray investigations. This test should be done after consultation with your doctor.

Q Does this test replace coronary angiography?

A Coronary angiography is still the gold standard to evaluate the heart arteries. However, it should ideally be reserved for those persons who have definite signs and symptoms of heart disease or have had a heart attack (MI). For, those individuals who are at high risk without symptoms, or in whom the symptoms are not definite pointers towards heart disease, or in whom other non-invasive tests (stress test, thallium etc) are ambiguous, CT angiography is the ideal technique for excluding the presence of heart disease.