Purpose of the Test: Cardiac computed tomography angiography (or CTA), is a noninvasive test that uses special X-rays to focus on the coronary arteries. It allows the physician to see if you have blockages in the heart arteries. As part of the test, you will be given an iodine-based contrast material (or dye) that will be injected into a vein in the arm to see the vessels in your heart. This test will reveal plaque buildup in your coronary arteries – both calcified “hard” plaque and “soft” plaque, which can be even more dangerous. Having blockage in the coronary artery is one of the main reasons for chest pain, and can lead to a heart attack.
Please discuss with your doctor whether this test is right for you, specifically:
- Pregnant women should not have this X-ray test. If there is the possibility that you are pregnant, it must be verified before the test.
- Patients with poor kidney function, not requiring dialysis, should not have this test with contrast. If you are on dialysis, you can have this test.
- Patients with severe allergic reaction (or anaphylaxis) to IV contrast (dye) should not have this test. If your allergic reaction is mild, you may require pre-medication with Prednisone/Benadryl.
Locations:
- Starr Pavillon, 520 East 70th Street, J-0, New York, NY 10021
(Between York Ave & East River. After entering the building, it is to the left of the Security Guard Station) - 2315 Broadway, 4th floor, New York, New York 10024
(Upper West Side Facility)* (Between W 83rd and 84th Street)
*Your CT should be scheduled at the Upper West Side Facility, if you have a resting heart rate of >75 beats per minute, an irregular heart rate (such as atrial fibrillation, arrhythmia or ectopic beats), or coronary artery bypass surgery.
Arrival Time: Plan to arrive 10 minutes prior to appointment time
To reschedule: (212) 746-6000
Duration of Test: ~ 1.5 - 2 hours (the scan takes 20-30 minutes, and there is at least one hour of prep to lower your heart rate)
Preparation for Test:
- For coronary artery exams, do not take the following medications 48 hours prior to the CT exam: Viagra, Cialis, Levitra or other phosphodiesterase Type 5 Inhibitors medications. Doctors will give nitroglycerin under the tongue at the time of the CT scan to make the coronaries look larger for better image accuracy. Please check with your doctor if it is safe to not take these medications. All other medications are okay to take and should be taken at their usual time, even on the day of the CT scan.
- If you have diabetes mellitus and are taking metformin, you will have to stop this medication for 2 days after the CT scan.
- Do not apply lotions, oils or powders to the chest area.
- Please do not eat for 1 hour prior to the exam except for medications.
- Upon check in, your heart rate and blood pressure will be checked. If the heart rate is elevated, you may be given oral medications to slow your heart rate. It is important to have a slow heart rate to have clear images (similar to holding still when taking a picture with a camera to prevent a blurry picture). The heart rate lowering medication will either be a beta blocker (metoprolol) or a calcium channel blocker (diltiazem).
- You will fill out paperwork, change into a gown and have an intravenous (IV) catheter placed.
- Heart rate and blood pressure will be checked again after approximately 45 minutes of receiving the heart rate lowering medication. You may need more medication through the IV if your heart rate is not slow enough. Once your heart rate is at goal, you will be taken to the CT scanner.
What should I expect during the test?
- For the CT scan, you must lie flat on the scan table. The scanner is a short tube that has an opening in the middle a little wider than your body (your head will never be “inside” the scanner).
- Before the scan begins, we will put 4 stickers with wires on your body that attach to a heart monitor, so that we can check your heart rate at all times during the scan.
- You cannot move or breathe while we are taking pictures. You will be asked to hold your breath for approximately10 seconds For each breath-hold, we will take a set of pictures.
- Before we scan, you will be given nitroglycerin under your tongue to make your coronaries larger and easier to see. Let the CT nurse/technologist/doctor know if you cannot take this medication (i.e. if you have medical conditions like severe aortic stenosis, hypertrophic cardiomyopathy or cannot stop phosphodiesterase Type 5 Inhibitor medications for 48 hours).
- We will inject a small amount of contrast fluid or “dye” into your IV catheter. The contrast allows us to see the arteries in your heart better. This is the same IV contrast commonly used for CT scans of other parts of the body. The contrast fluid often makes people feel warm or even hot when it is injected. This is a normal reaction to the dye and usually goes away within a few minutes after the scan is over.
- We will take 4-5 sets of pictures of your heart.
- Our Cardiac CT physician will review your pictures to make sure they are of good quality before sending you home.