CT Angiography

[Kind51]

How accurate is CT angiography for detecting narrowed or blocked arteries?

[Coffeelover2]

I only had mild narrowing of one artery and it was shown pretty clearly by a CT machine. It showed a clear 3D picture

[Kind51 in reply to Coffeelover2]

Thank you for your reply. I have had a CT scan which showed clear arteries and yet I suffer daily angina. I was wondering what other people's experiences have been and if if a traditional angiogram is more accurate.

[Coffeelover2 in reply to Kind51]

OCT or IVUS seem much more accurate but they rarely seem to use those imaging methods. They use infrared or ultrasound to get an imagine inside the arteries.

It could be that your angina is caused by spasms that would need an angiogram with a chemical that demonstrates that you have spasms.

All these are invasive tests though.

Have you had an MRI with contrast as that is often gold standard?

[Milkfairy Heart Star in reply to Coffeelover2]

Do you live with Angina/ ischaemia non obstructive coronary arteries ANOCA/ INOCA, microvascular angina or vasospastic angina?These are complex and difficult to diagnose types of angina.

Microvascular angina can in some cases be diagnosed by a cardiac perfusion MRI.

Invasive functional angiograms use adenosine and guide wires to measure how the blood flows through the small blood vessels to diagnose microvascular angina and then another chemical acetylcholine is used. If the coronary arteries constrict in response to acetylcholine then coronary vasospasms, vasospastic angina is confirmed.

My vasospastic angina was confirmed by a functional angiogram 2014.

Unfortunately this type of angiogram is still not widely available.

[Kind51 in reply to Milkfairy]

Thank you for your reply. I have been diagnosed with Vasospastic Angina/Microvascular Angina but I would like to know for sure what is going on because I'm unable to exercise in a normal way. I have experienced an improvement with the warmer weather however my symptoms continue. I suffer daily chest discomfort/angina at rest. I experienced a particularly painful sudden episode the other day at rest which was relieved with my GTN in about 5 mins which makes me think this must be Vasospastic Angina. It was a pinching, squeezing sensation. I thought I was about to take a heart attack. Air quality seems to affect me. Worse on misty/rainy days. Even the cool air conditioning in the car can be enough to worsen the pain.

[Milkfairy Heart Star in reply to Kind51]

Many people are given a presumed diagnosis. I was relieved to have my vasospastic angina confirmed by an angiogram with acetylcholine. I wanted to know why I have my symptoms.

It also means you can be offered the correct treatment. The treatment for microvascular and vasospastic angina are different.

Some people with microvascular angina experience chestpain at rest.

I will experience chest tightness and breathlessness during an unstable phase of my vasospastic angina.

These conditions are complex!

I would have difficulty having a CT angiogram as beta blockers are often prescribed to slow your heartrate. Beta blockers can make coronary vasospasms worse.

I ended up in hospital with unstable angina after being prescribed beta blockers.

The warm weather reduces my symptoms too. I am hoping for a warm summer!

[Kind51 in reply to Milkfairy]

I can imagine you would be relieved to get a proper diagnosis. At least you know for sure what you are dealing with. I've noticed there are similarities in the symptoms and triggers of Vasospastic Angina and Microvascular Angina.

I would like to know the exact cause so my treatment can be better targeted. I agree, these conditions are complex. The overwhelming fatigue which comes with this condition is very challenging.

I'm hoping for a nice summer too and plan to spend lots of time outdoors to make up for not being able to get out much during winter because of severity of condition.

[sandandkev]

It's very good,I've had one and my cardiologist said it was better at seeing things than echogram or bubble test

[Kind51 in reply to sandandkev]

Thank you for your reply.

[Hel52]

I had CT scan in February it’s very good it gives very clear images of your heart.

Unfortunately most mine images weren’t great because my heart was racing and the images weren’t clear so I am now waiting for a stress test the letter arrived 8 weeks after the CT scan I am still waiting for an appointment everything takes for ever.

Best of luck Hel52

[Kind51 in reply to Hel52]

Hello Hel52, thank you for your reply. Yes, the cardiology testing waiting times are long and do seem to take for ever. Best of luck with your stress test.

[Hel52]

👍

[TasteLessFood4Life]

I think the accuracy for a positive result or presence of narrowing is above 90%. So, yeah pretty accurate and preferred method for initial testing, as it is non-invasive procedure.

While it can detect the presence of stenosis, it is less accurate at the degree of stenosis or narrowing. It can over/under estimate.

[Kind51 in reply to TasteLessFood4Life]

Thank you for your reply - this is helpful.