Screening can identify hidden heart disease in apparently healthy people. This early detection allows you to reduce the future risk and complications associated with heart disease.
What is Advanced Coronary Screening ?
It is a way of finding out if you have early stage coronary artery disease. The process of coronary artery narrowing, due to atherosclerosis, starts years before symptoms occur. These days modern imaging using superfast CT scans can detect early plaque calcium deposits in the artery wall. The amount of plaque seen is a better predictor of future events than the risk estimated by the statistical models. Scans can identify risk that the heart disease models can miss.
Who should have Advanced Coronary Screening ?
Coronary screening with cardiac CT is most useful in men over 45 and women over 55 who have an intermediate ten year heart risk (10-20%).
If you feel you have significant risk factors, but no symptoms of heart problems a scan will be able to refine your risk of developing heart disease or a heart attack within 10 years.
We take a personalised approach and discuss risks and benefits in person with everybody we scan.
There are 2 types of scan
Coronary Artery Calcium Score Scan
This is the basic cardiac CT scan performed without x ray dye. It detects chalky deposits in the artery wall contained in mature coronary plaques. The amount of calcium is represented as a score which is a reliable way of predicting future risk. This scan cannot see the inside of the artery to show exactly where narrowings are.
CT Coronary Angiogram
This is a much more detailed scan. X ray dye is injected through a small tube in your arm vein and the scan is timed to take pictures of the dye travelling through your coronary arteries. The scans are reconstructed using software to create high detailed 2D and 3D images of the vessel and can show narrowings due to soft plaque with a high degree of accuracy. Soft, early plaques are more likely to cause heart attacks. If no plaque is seen your risk of events is extremely low.
Which Scan Should You Have?
Dr Hyde will make a recommendation to you based on information about your age, sex and risk factors during your consultation. The risks, benefits and alternatives will be fully discussed before making the final decision. In general men and older patients have more calcium.
What are the benefits of Advanced Coronary Screening?
- If higher levels of plaque are detected then you have the opportunity to make changes to your lifestyle and take medication safe in the knowledge that it is the right thing to do. Studies have shown that patients who know they have narrowings are more likely to take statins.
- If you have lower levels of calcium than expected or no disease is seen and your pre test heart risk is lower than 20% then studies suggest you are unlikely to benefit from statin treatment.
- The scan can find other illnesses at an early stage, we have detected a lung cancer at its earliest stage allowing curative surgery.
What are the risks?
- The scans use ionising radiation which potentially increases your lifetime risk of cancer. Fortunately the modern CT scanner at the Great Western Hospital in Swindon is able to scan with a very low X-Ray dose (lower than one year’s background radiation).
- The 3D scan uses X ray dye or contrast to provide clear pictures, there is a tiny chance of an allergic reaction. Contrast can be harmful for patients with known kidney problems.
- The scan will also look at other organs such as lungs and bones. Occasionally abnormalities will be seen which require further investigation.
How to prepare and what to expect on the day of the scan?
A Calcium scan will take 5 minutes and a CTCA will take 15 minutes. Most time is spent preparing you for the test.
Before the Scan
- Please avoid caffeine and nicotine the day of the scan.
- Please avoid food and drink 4 hours prior to the scan.
- You will fill in a safety questionnaire about your health allergies and kidney function. We may need to postpone the scan in case of severe allergy. You may need a blood test to measure kidney function prior to the scan.
- Viagra and other medicines that are contraindicated with nitrates should be avoided for 24 hours.
- You can drive to the scan and will be able to drive after.
- Please wear loose fitting clothing, women will be asked to remove bras with metal underwiring. Chest piercings should be removed where possible.
- If you were asked to take a beta blocker tablet on the day. Please take it 2 hours before your appointment time.
- In intravenous (IV) line will be inserted in your arm in our recovery area.
After the Scan
- The team will check the picture quality before you leave the room.
- Occasionally you may feel nauseated or dizzy and need a little while to recover, this should pass. Once you feel well you can go.
- A Radiologist will read the scan and send the report to Dr Hyde you will not usually get a report on the day.
How much does it cost?
Please note these are Self funding prices only.