However, risk prediction is an inaccurate science. Too often, someone thought to be at low or intermediate risk has an unexpected heart attack or dies from the malfunctioning of their heart’s electrical system (sudden cardiac death). A noninvasive imaging test called coronary CT angiography (CTA) may identify these patients before it happens.
“CTA has emerged as a very useful test for risk prediction when used in the right patients,” says imaging cardiologist Milind Desai, MD.
CTA has two important qualities:
These qualities make CTA valuable for use in patients admitted to the Emergency Department with chest pain. “A normal CTA generally means the patient can confidently return home in a timely manner. On the other hand, a patient with significant coronary disease can be quickly identified and admitted for treatment,” says Dr. Desai.
Coronary CTA is also helpful for patients:
Coronary CTA is not a good screening tool for heart disease in people without symptoms. Image quality tends to be poor in obese patients and those with heavily calcified arteries, high or irregular heart rates and small stents.
As yet, coronary CTA is not the right test for patients considered at high risk based on prior test results, prior revascularization or multiple risk factors. “These patients are more suitable for a cardiac catheterization,” says Dr. Desai.