Cardiology News South Africa

CT angiography outperforms stress testing in diagnosing coronary artey disease

A study published in the American Journal of Cardiology comparing stress testing and 64-multislice coronary computed tomography angiography (CTA) shows that the latter has better diagnostic ability for obstructive heart disease.

Dr. Clive Sperryn, president of the Radiology Society of South Africa (RSSA) said that: “The data from this study showed that coronary CTA is better than stress testing in diagnosing obstructive heart disease.”

Men have a greater risk of heart attack than women do, and they have attacks earlier in life. Even after menopause, when women's death rate from heart disease increases, it's not as great as men's.

Single CT scans are widely used in medical imaging, but since a beating heart doesn't stand still for a picture, these scans have been less useful for imaging the heart. The development of multiple detectors or Multislice CT systems has allowed imaging of the heart, which moves as it beats. This provides a level of detail not previously available.

Computed Tomography (CT) is a radiological test that combines the technology of a conventional CT scan with that of traditional angiography to create detailed images of the blood vessels in key areas of the body, including the heart.

CT imaging involves the use of x-rays which obtain multiple sectional images which are then reconstructed by a computer into three-dimensional pictures.

As opposed to CTA, stress testing provides your doctor with information about how your heart responds to exertion. When your heart is working hard and beating fast, some heart problems are easier to diagnose. During these tests, your heart is monitored using images or through dime-sized electrodes attached to your chest, arms or legs. Stress testing helps to diagnose heart disease or to see how serious this disease is in those who are known to have it.

Once a stress test has been done and a potential cardiac problem is revealed, the cardiologist should get a close-up look at the arteries in the heart, to see whether there might be any blockages that require an intervention (such as angioplasty or stent). This can be done by means of CTA.

“If no blockages are found, CTA provides a less expensive way of ruling out the need for additional intervention. Modern CT scanners can scan through large sections the body in just a few seconds. Such speed is beneficial for all patients,” Dr. Sperryn said.

According to the Radiology Society of North America (2008)1, other benefits of CTA include the following: it may eliminate the need for surgery. If surgery remains necessary, it can be performed more accurately. CTA is able to detect narrowing of blood vessels in time for corrective therapy to be done. No radiation remains in a patient's body after a CT examination, and X-rays used in CT scans usually have no side effects.

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