My Cardiologist has offered me a CT coronary angiogram to find out what may be causing my angina symptoms. My symptoms are moderate (no pain in the arm or jaw etc) with just a tightening in the centre of the chest with very brisk uphill walking. The discomfort is actually worse when i am anxious about something such as a domestic problem.
My big worry is that, of all the various heart tests the Ct coronary angiogram appears to use the most radiation. A BHF booklet (10 years old) that i have says that the scan gives you three years worth of radiation whereas a standard chest x-ray for example gives out only one and a half days worth!!
I have to admit i am now scared and have put off booking the scan for a week. I'm 74 years old and can still enjoy my walks with no problems at a lesser pace although the anxiety tightness still comes on. Is it really worth the risk at my age and with moderate symptoms?
A happy Christmas to all.
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MrPrognosis
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Does your Cardiologist think you really need to have this done as you say they have offered it you where when I have to have things done they have told me this needs doing
I would have been asking what difference will it make to you to have it done and are any risks in their opinion worth it in your case
This has to be your choice weighing up the pros and cons of it and I know you will make the right one for you and members will come along see your post and share their wisdom with their experiences and thoughts
Let us know what you decide to do and how you get on x
Thanks for your response. My appt with the Cardiologist was frustrating. I had filled out a 'pain' diary as instructed but it was not even looked at. I also suffer with chest 'spasms'(not pain) when i walk briskly and i think the Cardiologist took these as my reason for being referred to the chest pain clinic rather than angina. He did not think at that time that a CT scan would be beneficial as the spasms are apparently nothing to do with my heart. After my GP re referred me he now accepts that i get angina symptoms (they were in the diary!) and has offered the scan.
When I had my first mild chest pain like you I asked for the CT rather than the angiogram which was advised as I reckoned the CT was less invasive. Yes there’s the radiation. Anyway according to the CT which shows calcium I should be dead. This was in 2017 and I was 65. Then I did have the angiogram and one stent to LAD. Have been almost 100 pc well in that area since, thanks to the drugs I’m sure. I regret not going for the angio in tne first place instead of the CT. That’s my experience but not in a position to advise of course.
Personally I would accept any test to investigate chest tightness. Any hint of chest tightness would scare me. CT scans would not be used so widely if they were considered dangerous.
Thanks for your response. I think i probably have to go for it.
All the best
I can definitely see why you are concerned. I did not have alot of choice when I had mine as I was at the hospital because of my strange ecg and low blood oxygen levels. Basically they wanted to find what was causing these issues. Personally I had to go along with it all, you can read my bio. The contrast agent was put in my arm and when it was pumped in it made you think you had a full bladders. Fortunatly nothing un towards was found on that scan it was the echo of the heart that found my congenital heart issue. As they say the rest is history. It is your choice but the contrast agent does help to show up the blood vessels and to eliminate any blockages. However when I had my mri a few months later I did not have any contrast agent wether it was because I had already had some that year or wether they use different chemicals I don't know but what do you do, put your trust in them to get to a conclusion? I would have another ct scan. But my next excitement is a heart catheterization. So what can I do, iam not looking forward to it, but some say it's not that bad, but some say sky diving from a perfectly good aircraft is not that bad. From a fellow anxiety sufferer. Take care.
Thank you for your reply. Anxiety is of course very important. I have suffered badly over the years with it. I already have aortic valve stenosis and just being informed about that could trigger other stuff in a frightened little chap like me! I can't even experiment with the GTN spray that my GP gave me as you are not supposed to use it if you have the valve stenosis. I don't know what to do. Maybe just enjoy Christmas first! Your last sentence made me smile which is always nice. Thanks for that.
Well I try to find a light side to all this, hard I know. Here is another little story when I had the mri I was a bit anxious. Any way it is a bit of a tight fit when laying inside, that's why I prefer a ct scan more room, bigger donut hole. Any way after 45 minutes to an hour laying in this machine they get you out, well with all the nurses and technicians helping me out I felt like I was getting out of apollo 11 space craft. I did originally get gtn spray before I knew of my congenital issue, it works but gives me head ache. That's the trouble with the medication the side effects. Fortunately all my other valves are OK, which can and where seen on the mri it's the tricuspid valve that's manufactured wrong, but the anxiety which I have suffered with for many years is the biggest issue. But anxiety and depression can be caused by heart issues and vice versa. Any way you take care and enjoy Christmas.
The BHF website gives this information about CT angiograms
"The radiation levels associated with both CT coronary angiography and CT calcium scoring are low, similar to the annual background radiation that people are exposed to over the course of a year. However, because of this radiation, they should only be carried out only when really necessary.
Thank you very much for your reply. I will take on board your good advice and get some more information, but i might just try to enjoy Christmas with the family before deciding what to do.
My partner had 2 x CT scans, a CT PET scan and an angiogram within 8 months and we “joked” he’d be glowing.
I think it’s a case of weighing up the pro’s and cons for your particular situation, but I’m very glad my partner had them as it turned out he needed a triple bypass.
Hi. I’ve had a couple of CT coronary angiograms with no issue. My issue would have been if I had not had the first one, my 95% blocked right coronary artery would not have been found and I probably wouldn’t be writing this. I was shown the footage taken and could see as clear as day the blood struggling to get through my artery. The result a few weeks later was the addition of a stent being fitted. I was 55 and now 61. They wouldn’t use such equipment if the risk of doing so outweighed the benefit. Personally, I think it’s a no brainer. Best of luck to you.
Thanks Sooty. On a long walk yesterday i was fine but on a short faster trip to the local shop in the evening the discomfort was there. I feel i have to go ahead with the scan.
The average risk of developing cancer from a single CTCA was approximately 1 in 1600, and the average risk of dying from cancer from the CTCA was approximately 1 in 1900.
Over the past five years, technological advances in CT, most notably the introduction of multislice scanners with faster gantry rotation times, have made possible a rapid, accurate, and noninvasive assessment of the cardiovascular system.
Given that a CTCA will accurately be able to provide you information regarding chest pain that can save your life tomorrow, its probably a good option, but of course your call.
My BHF booklet is years out of date and as you say tech advances have improved the outcomes for patients. I suffer with bad anxiety and any stressful situation can bring on the discomfort. The replies here have convinced me that i have to find out what is going on.
I have been informed, as well as researching CT Scanner manufacturers websites, that through advanced technology these machines now deliver Low Radiation….a lot less than the old ones did.
I would speak to one of the BHF nurses and be guided by them, rather than relying on online sources. Personally I would say it’s worth having it done. Best wishes .
I've had three CT scans this 13 months. I wouldn't be here if I hadn't. I've been told one CT is equivalent to 100 x-rays. Harsh but not as life-threatening as sudden cardiac arrest. I would say do it. Most people diagnosed before heart events happen have found their problem thru CT Angiograms. Alternatively you could refuse and ask for an invasive Angiogram where they use X-ray whilst looking directly into your heart with dye. However, I would say this has higher risks and is normally only done if the CT Angiogram shows issues.
Thank you for your information. All the replies here have made me feel much better about getting the scan done. I suffer with terrible anxiety which doesn't help.
It's definitely a case of risk vs benefit. In this case its definitely worth going ahead I would say.I'm a radiographer and would go ahead with it. Radiation can seem really scary but the chances of anything bad coming of it are so slim. We try to reduce the amounts of radiation people receive and many things are taken into consideration before it goes ahead so I say put trust in the system. It wouldn't be accepted to do if your situation didn't tick the boxes in the protocols.
I’ve had 3 angiograms over 10 years and think it’s very important to have it done to find out if anything serious needs to be dealt with to put it right as quickly as possible. X
Jezza_H gives some very helpfull statistics - it is more likely that you will be involved in a vehicle accident than suffer ill effects from a CT scan - do you hesitate every time you need to get into a car?
one of the benefits of a scan are that they clarify your health situation and, in my opinion, this massively outweighs the uncertainty and concern over symptoms and their cumulative effects
Hmmm... I've had 3 angiograms over the past 13 years (and throw in a few chest X-rays) and I note that the doctors ALL wear lead aprons but then they're exposed all the time they're operating. Obviously better not to get 'fried' but what are the alternatives to an Angiogram, each case is different?
Well there's just looking and there's fixing, isn't there. I think actually performing procedures eg, inserting a stent would be impossible in one of those gigantic MRI machines, I'm not sure about a CT scan though.
Oh goodness if I worried about that I'd never have any tests. I've had 6 CT scans in teh past 3 years for various things; dozens of x rays. I can't have an MRI scan so it has to be CT scans for my spinal problems. Only once, about 20 years ago did the x ray dept comment on how many x rays I'd had. BY all reports I should be glowing green by now LOL. If a scan is necessary so be it. It would cause m ore harm NOT having it than the minute risk if you do. That three years that's mentioned is simply 3 years worth of the normal background radiation we all get. It's minimal.
Dozens of X-rays? I read recently though that mammograms to detect breast cancer increase risks by a staggering amount!
"New research published in JAMA Oncology reveals that mammography is responsible for an astounding 84 percent higher rate of breast cancer deaths over a 20-year surveillance period."
Yes literally dozens of x rays and annual mammograms and probably about 8 or 9 CT scans in all; all of which have been deemed necessary. I'll take the risk.
Basically a ct scan is of no consequence to a 74yr old and will not effect your lifespan in the least. The main people that may suffer from too much radiation later in life are children and younger adults. On the other hand a blocked artery or two will have serious consequences if you do not get it sorted. If you feel very strongly about it why not try to opt for a basic angiogram which they will have to do anyway if they need to intervene. Either way get it checked and if all good this should relieve your anxiety. The body tissue of older people are less sensitive to radiation so I can not see any problem whatsoever.
A quote from Google: A mammogram produces more - 0.6 mSv, or the same as a dozen flights across the Atlantic. A CT scan is higher still at around 7 mSv, about the same if you spent a year in Cornwall where the sun exposure and radioactive rocks pump up the levels of 'natural background radiation'.16 Sept 2016. I would have it done in a heartbeat. Pun intended.
My cardiologist suggested a heart CT scan after I had a pacemaker implanted due to having unexplained complete heart block two years ago. I was also concerned about the radiation exposure so chose instead to have an MRI with contrast of my heart.
In the last 2 years I have had one Cardiac CT scan and two lung CT as part of the NHS lung health check and another planned in 6 months as apart from a slightly enlarged heart following a HA in 2010 I also have mild Emphasyma and Bronchiectasis and COPD from a lifetime of flour inhalation as a baker. The small amount of radiation used causes no side effects whatsoever, but I did have a slight reaction to the dye injected for the Cardiac CT. I am 72 and i am thankful for all the intervention of modern methods of diagnosis. Go ahead and have you cardiac CT as it may help to assess the correct treatment for your condition
If you need an angiogram it may be better to get a physical one..invasive but a relatively quick proceedure and the advantage over a CT angiogram is that they can insert stents at the same time if found necessary...in a CT ..the Radition is high and if they see something ..you will still need to get the physical angiogram..I have had one done..literally pain free except for getting that plaster off after a few days..they went via my wrist..some go through the groin..you can talk to your cardio about that..but if they think you need to do one..then you should..I personally would do the physical version..but good luch with what ever you decide
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