Emergency rooms and cardiologists worldwide see millions of people annually who complain of chest pain. There are many reasons for chest pain, some indicative of a heart problem and others not. Since not all chest pain has to do with the heart and not all heart pain is in the chest, doctors leverage advanced technologies, such as cardiac Computed Tomography (CT) scans to confirm whether an incidence of chest pain indicates underlying heart disease.

What Is A CT Cardiac Scan?

A CT cardiac scan produces a cross-sectional image of the heart, associated blood vessels and surrounding structures. The procedure employs multiple X-ray images and a computer to create images that medical professionals use as a diagnostic aid.

Computed tomography is an advanced technology that can be used with or without intravenous (IV) contrast (dye) for detailed visualisation of any part of the body, including organs like the heart, bones, muscles and blood vessels.

What Can Doctors Learn from Cardiac CT Scans?

A CT cardiac scan can reveal extensive information about the heart and its structures that can help doctors with diagnoses and treatment decisions. Here are examples of vital information that doctors can see from a CT cardiac scan:

• The coronary arteries and whether there is any narrowing or build-up of plague
• The size and shape of heart chambers, possibly revealing abnormalities
• The condition of the heart valves, whether they are normal, narrowing or leaking
• The condition of the heart muscle, whether it is damaged or scarred
• A clear picture of the aorta and other key blood vessels, which can reveal aneurysms or vascular diseases
• Signs of congenital (since birth) heart defects, like holes in the heart or unusual connections between heart chambers
• An indication of the amount of calcium in the coronary arteries, which is an indicator of coronary artery disease
• An indication of the state of the pericardium (the sac surrounding the heart), whether it is inflamed or filled with fluid
• Tumours in the area of the heart

When Do Doctors Call For A CT Cardiac Scan?

A CT cardiac scan can be an invaluable aid when evaluating chest pain, particularly if the doctor is not able to make a clear diagnosis but suspects an underlying coronary or cardiac condition. A CT scan can help to rule out misleading factors that can lead to the wrong diagnosis and inappropriate treatment.

Doctors usually order a CT cardiac scan for chest pain in the following situations:

1. When a physical examination, ECG, and blood tests do not reveal a clear reason for the chest pain, or the doctor wants to rule out heart problems as a possible cause.
2. When a patient has a high risk of coronary artery disease (CAD) due to high blood pressure, high cholesterol, diabetes, smoking, or a family history of heart disease.
3. When chest pain is not typical of heart disease but the doctor is not convinced that the person doesn’t have heart disease.
4. When a person is at an intermediate risk of CAD based on the presence of risk factors and clinical assessments. When calculating an individual’s risk of coronary artery disease the information provided by a CT cardiac scan can be a deciding factor.

Risk factors for CAD include:

• Hypertension (moderately high blood pressure)
• Family history of early heart disease
• Fairly high cholesterol levels
• Diabetes or prediabetes
• Overweight or obesity
• Smoking
• Sedentary lifestyle

1. When preparing for surgery involving a patient who has a history of unexplained chest pain or is at a high risk for CAD, a doctor may order a CT cardiac scan to determine the potential risk of heart complications during surgery.
2. When a patient has undergone a major procedure, such as coronary artery bypass grafting (CABG) and the doctor wants to see if the operation was a success by evaluating the status of the coronary arteries.
3. When it is necessary to investigate other possible causes of chest pain that may be related to the heart, such as aortic dissection, pulmonary embolism, or congenital heart defects.
4. When planning for and anticipating complications associated with procedures and surgeries such as robotic heart surgery, transcatheter or /percutaneous valve procedures, and arrhythmia ablation procedures.