Heart scan produces 3-D picture for diagnosis

By Dr. Bharat Sangani, McClatchy Newspapers Q: What is a 64 slice CT scan of the coronaries? A: The 64 slice CT scan of the coronaries takes 192 images per second that will produce three-dimensional pictures of the heart anatomy and the arteries. The purpose is to diagnose coronary heart disease or blockages in the heart and congenital deformities. The CT scan will also give the physician a calcium score. Q: How does the CT scan of the coronary arteries compare to a heart catheterization? A: The heart catheterization is an invasive procedure requiring at least a one-day stay in the hospital. The large artery in the groin area is punctured and the contrast injected to take pictures of the coronary arteries to determine if there are blockages. The 64 slice CT scan is a noninvasive procedure performed at a diagnostic center. A simple IV is started and the contrast is injected. The test takes less than 15 minutes. The risk for the patient is much less with the CT angiogram than the invasive heart catheterization. Q: What happens if blockages are found on the CT scan? A: If the stenosis in an artery is significant then the physician will recommend an invasive angiogram for a possible stent insertion. Q: What is significant about the calcium score that is obtained with the CT scan? A: Calcium in the coronary arteries is a sign of coronary artery disease. The CT scan will give a calcium score to determine the severity of calcium buildup on the walls of the arteries. Q: Is the preparation different for a coronary CT scan? A: You will need to remove jewelry or any metal objects that are in the way of the picture. The recommendation is nothing to eat or drink after midnight the night before the test. Electrodes will be put on your chest to monitor your heart rate and rhythm. The heart rate must be below 70 for better images. If the heart rate is greater than 70, then you will be given a beta blocker tablet to slow the heart rate down. Q: What is considered a high cardiac calcium score? Q: The higher the number, the more plaque you have. The score of zero means no plaque is present and you have less than a 5 percent chance of having heart disease; 1-10, a small amount of plaque is present and you have less than a 10 percent chance of having heart disease. Lifestyles changes of no smoking, losing weight and exercise will be recommended; 11-100, plaque is present, you have mild heart disease and chance of having heart disease is moderate. Lifestyle changes are recommended; 101-400, moderate amount of plaque is present. You have heart disease, and plaque may be blocking an artery. Your chance of having a heart attack is moderate to high. More than 400, a large amount of plaque is present. You have more than a 90 percent chance that plaque is blocking one of your arteries. Your chance of having a heart attack is high. Q: How will a high calcium score be treated? A: Remember, the higher the score, the higher chance you have of having heart disease. The most important issue when it comes to the heart is lifestyle changes to reduce the risk. ___ (c) 2006, The Sun Herald (Biloxi, Miss.).
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