Using coronary CT angiography (CCTA) to identify which patients with suspected coronary artery disease (CAD) really need invasive angiography can lower the overall cost of diagnostic testing without sacrificing safety, suggests a randomized trial published Dec. 12 in JACC: Cardiovascular Imaging.
When compared to previous, exercise-based tests, this newer screening method turns out to be leading to many more surgeries—and subsequently higher medical costs—without the data to show that it's actually helping people live longer or stay healthier, according to an analysis published online Tuesday in JAMA, The Journal of the American Medical Association.
In the basement laboratory of an Ohio hospital, a cardiologist accidentally injects a large amount of dye into the small vessels of a patient's heart during a routine imaging test. To the doctor's great surprise — and relief — the dye doesn't send the heart into a fatal spasm, and this happy accident marks the birth of modern cardiac imaging.
Dr. Karlsberg and other cardiologists who support widespread use of CT heart scans argue that they can reduce the need for other tests — like conventional angiograms, which can find plaque but require a catheter to be threaded through the arteries. Conventional angiograms are more expensive than CT scans and carry their own risks.
If a CT heart scan finds plaque that a doctor intends to treat with a stent, a conventional angiogram will still be necessary to determine where and how to implant the stent. So a CT scan does not always eliminate the need for a conventional angiogram.
The invasive coronary angiography is the gold standard in coronary artery disease evaluation. It is one of the most common operative procedures worldwide. This topic covered in detail would be extensive and the author provides his own, personal view of the indications, technique and complications of this diagnostic test.
Coronary angiography is only one method used to diagnose a variety of heart and vascular diseases, disorders and conditions. You should discuss different screening options with your doctor or healthcare provider to best understand which option is right for you.
Angiography is a way to examine the inside of your heart's blood vessels using special X-rays. Find out what you can expect when you have the procedure.
Coronary angiography also might be done on an emergency basis, such as during a heart attack. If angiography shows blockages in your coronary arteries, your doctor may do a procedure called angioplasty (AN-jee-oh-plas-tee). This procedure can open blocked heart arteries and prevent further heart damage.
Some people get a short angina-type pain during angiography. This soon goes.
The dye may give you a hot, flushing feeling when it is injected. Many people also describe a warm feeling in the groin when the dye is injected - as if they have 'wet themselves'. These feelings last just a few seconds (and the operator will tell you when they are about to inject the dye). Rarely, some people have an allergic reaction to the dye.