chest CT scan

[ScoobyDoo71]

I recently have had some ongoing episodes of chest/ back pain that appear worse on exertion and ease with rest. There has been a query if this could be microvascular angina. I did have angiogram few years ago which showed as clear.

I recently got sent for a CT scan which I thought was going to be cardiac but when they did it I was told it was not looking at coronary arteries but a chest CT scan.

does anyone know how much cardiac detail will be seen on a chest CT ?

Thanks

[MichaelJH Heart Star]

First things first! The standard angiogram (the "gold" standard) will clearly define narrowing of the main (macro) vessels like the LAD and RCA, but the blood vessels (micro) involved in MVA are far to small for this technique!

A chest CT scan is usually used to identify other issues like tumors in the chest cavity, blood clots on the lung, etc. Some heart issues will show up but are very much dependent on the specific scanner, what they are looking for, etc. When looking for MVA they use a CT Perfusion scan.

I think you really need to talk with your GP or cardiologist.

[Milkfairy Heart Star]

Just to add to Michael's comment.

Microvascular dysfunction which causes microvascular angina can be diagnosed using a cardiac perfusion MRI.

Increasingly Cardiologist's are performing invasive functional angiograms, when techniques are used to measure how the blood flows through the small blood vessels to diagnose microvascular angina.

Recent research has shown that a stress echo can help identify patients who have microvascular angina.

Microvascular angina is thought to be due to the inability of the small blood vessels to dilate or stay dilated in response to extra demands like exercise.

[ScoobyDoo71 in reply to Milkfairy]

Thanks, I’m a bit of a challenge despite having MRI compatible pacemaker they are reluctant to do cardiac mri.

My echo windows are really poor so limited with imaging.

Key symptoms are very much on exercise and previous CPET showed poor VO2 with report citing cardiac cause.

It is so frustrating and feel like being passed from pillar to post with no clear diagnosis.