What is atherosclerosis?
Atherosclerosis, the thickening and hardening of the arteries, is the most common cause of illness and mortality in the industrialized world. Fifty percent of people in the Western world will suffer from atherosclerosis of the coronary arteries (the arteries that supply blood to the heart muscle) and/or arteries that supply blood to other vital organs such as the brain, kidneys, bowel, and lower extremities.
Atherosclerosis is caused by the narrowing and buildup of plaque layers in the arterial wall. It is more common in people with certain medical conditions, such as high cholesterol, high blood pressure, smoking, diabetes and obesity.
Heredity also plays an important role in determining the risk for atherosclerotic vascular disease. Symptoms caused by atherosclerosis, which depend on the involved organ, include chest pain—either chronic or sudden—when the coronary arteries are involved. The illness can also be symptomless, until it manifests suddenly, as is the case with heart attack, sudden death from arrhythmia, or stroke.
Imaging to detect atherosclerosis
Imaging of the coronary arteries is recommended in order to detect narrowed coronary arteries, localize the narrowed segments and determine how severe the blockages are. The diagnostic information obtained by CT coronary angiography identifies patients who require invasive interventional procedures and assists in selecting medications known to effectively treat atherosclerosis.
What is the difference between invasive coronary catheterization and a CT coronary arteriogram?
Cardiac catheterization is an invasive procedure used to detect and treat coronary atherosclerosis by delivering special tubes (called catheters) to the heart. Cardiac catheterization requires local anesthesia and hospitalization. By virtue of its invasive nature, cardiac catheterization entails a small risk of complications. The procedure provides highly accurate imaging of the arterial lumen (or cavity) but does not enable imaging of the arterial wall itself.
Tel Aviv Sourasky Medical Center’s non-invasive cardiac imaging team uses a state-of-the-art multi-slice CT scanner that is a highly effective alternative to invasive diagnostic catheterization.
About the CT coronary arteriogram and its benefits
The CT coronary arteriogram creates a large number of ultra-thin image slices. The processed images provide high-quality pictures of the arterial segments scanned throughout cyclic heart contraction and relaxation. The technology generates accurate two- and three-dimensional images of the heart and its arteries, delineating coronary artery anatomy, the precise location of narrowed segments, and characteristics of the vessel wall.
The discomfort to the patient during the procedure is minimal since the only requirement is an intravenous infusion line. The CT coronary angiogram captures images that conventional catheterization imaging cannot detect. Because the procedure is non-invasive, it is very
safe—similar to any other CT scan that utilizes iodinated contrast material.
The CT coronary arteriogram can identify small plaque buildup that does not cause narrowing in the arterial cavity but is an early manifestation of atherosclerosis. These findings can guide the prescription of a number of medications known to retard the progression of atherosclerosis.
A Tel Aviv Sourasky Medical Center cardiologist reviews the results of all CT coronary angiograms in order to develop a therapeutic plan with the patient and the referring physician.
Who is a candidate for this service?
The CT coronary arteriogram is primarily indicated for people who do not have symptoms referable to coronary artery disease, but are at risk for this condition because they have one or more risk factors, such as high cholesterol, high blood pressure (hypertension), a family history of coronary artery disease, a history of smoking, or diabetes. Patient with various types of chest pain can also undergo this test to diagnose the cause of their symptoms.
The test is suitable for patients with a regular heartbeat, who do not have severe kidney disease, and who are not allergic to iodine. All patients should undergo a cardiology evaluation prior to the procedure to confirm its appropriateness.