The Rise of the Coronary CT Angiogram

Stress tests are a thing of the past. Make way for coronary CT angiography. Wide-eyed medical students might gather around a treadmill in 20 years to observe a patient doing a traditional stress test as a “rarity” — to identify valvular disease, detect arrhythmias and gauge functional capacity, but not as a means to diagnose occlusive coronary disease.

 Coronary CT Angiography Versus Traditional Care

The ‘pro’s’ to using CCTA are compelling. If normal, we can convincingly exclude CAD as the etiology of the patient’s chest pain. I like tests that convincingly exclude diseases, and in general practice most tests that we use on a daily basis can’t do that.

 Coronary CTA for Suspected CAD Shows Advantages in Predicting Hard Outcomes Over 10 Years

On the heels of SCOT-HEART, this study begs the question: should anatomy be considered at least on par with stress testing for risk stratification?

 Coronary CTA Superior to Standard Care in Stable Chest Pain

Coronary computed tomographic angiography (CTA) was associated with a lower 5-year mortality rate from coronary heart disease (CHD) or nonfatal myocardial infarction in patients with stable chest pain compared with standard care alone...

 Should I Get a Coronary CT Scan?

There are 2 different types of coronary CT scans: a coronary CT angiogram and a coronary artery calcium scan. Both tests take place inside a standard CT scan machine, but there are important differences between them.

CTA an Effective Gatekeeper in Invasive Angiography Candidates With Suspected CAD

Selective referral for invasive angiography based on CTA results did not increase 1-year MACE and offered better diagnostic yield.

New Heart Disease Test Brings Higher Costs and More Procedures

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.

Radiation from heart imaging: What you need to know

Certain tests involve small amounts of radiation. Here's some perspective on the benefits and risks.

The Tell-Tale Heart Test: Stress Test vs. CT

The worst kind of assurance is false assurance. And that's been one of the problems with conventional cardiac stress tests, including the venerable EKG treadmill test, where you get all wired up and walk for your life.

Weighing the Costs of a CT Scan’s Look Inside the Heart

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.

And Here’s Why CTCA Is Useless

In the Emergency Department, that is, at least. A few years ago, there were several major studies evaluating the safety of a CT coronary angiogram-based study for the evaluation of chest pain in the Emergency Department. The constant challenge, however, has been specificity – not only with respect to whether the CT can accurately detect stenoses, but the clinical relevance of the stenoses.