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Procedures

Cardiac CTA

What Is a Cardiac CTA?

Cardiac computed tomography angiography (CTA) is an imaging test of the heart that determines if plaque buildup has narrowed a patient’s coronary arteries. Plaque is made of various substances circulating in the blood (such as fat, cholesterol and calcium) that deposit along the inner lining of the arteries and can reduce blood flow or even block it completely.

Cardiac CTA is a minimally invasive test in which CT imaging and intravenous (IV) contrast are used to visualize and evaluate the coronary arteries. CT uses X-ray pictures taken from multiple different angles around the body to create cross-sectional images that appear as “slices” of the heart and other organs. When contrast material is introduced into the bloodstream during the procedure, the coronary arteries and other vessels appear bright white, which allows the radiologist to better detect areas of vessel narrowing and other abnormalities.

Many physicians advocate coronary CTA for patients who have:

  • Suspected abnormal anatomy of the coronary arteries
  • Low or medium risk for coronary artery disease, including patients who have chest pain and normal, non-diagnostic or unclear lab and ECG results
  • Non-acute chest pain
  • New or worsening symptoms with a previous normal stress test result
  • Unclear or inconclusive stress test results
  • New onset heart failure with reduced left ventricle function and low or medium risk for coronary artery disease
  • Medium risk of coronary artery disease, before non-coronary cardiac surgery
  • Coronary artery bypass grafts

For patients with one or more of the above indications, cardiac CTA can provide important information about the presence and extent of plaque in the coronary arteries. Cardiac CTA can also detect other potential causes of symptoms such as a collapsed lung, pulmonary embolus, or aortic abnormalities. Your primary healthcare provider or cardiac specialist, possibly in consultation with a radiologist with expertise in cardiac imaging, will determine whether cardiac CTA is appropriate for you.

How Should I Prepare?

You will be asked not to eat or drink for 4 hours prior to the procedure.  You should not drink any caffeinated beverages such as coffee, tea, or soda the day of the exam.

Please arrive for your procedure with a responsible adult who can drive you home.

What Should I Expect?

After you arrive for your appointment, you will be escorted to a procedure room, where you will be asked to change into a patient gown.  You should remove all jewelry and other removable items such as glasses, dentures, and hearing aids. Women should always inform their technologist if there is any possibility of pregnancy.

A nurse will first insert an intravenous (IV) line into a vein in your arm in order to administer an iodine-based contrast agent. Radiology Ltd. uses only non-ionic contrast agents (the safest kind), but with all contrast agents there is always the potential for allergic reaction. Be sure to tell your technologist if you have experienced a reaction to CT contrast in the past. You may also be given a beta-blocker medication through the same IV line or orally to help slow your heart rate in order to improve image quality. Nitroglycerin, which will dilate your coronary arteries for better visualization, may also be administered as a tablet or spray underneath your tongue.

During the exam you will lie on a table that moves into the doughnut-shaped scanner. Electrodes (small metal discs) will be attached to your chest and to an electrocardiograph (ECG) machine, which makes it possible to obtain the CT images when the heart is not actively contracting. You may be asked to raise your arms over your head for the duration of the exam to improve image quality, and you may also be asked to hold your breath during scanning. Your technologist will watch you through an observation window and will be able to communicate with you at all times. CT scans are non-invasive and painless, though you will hear humming, buzzing, or clicking sounds as the CT machine moves to position you. It is very important to follow all instructions and remain extremely still during scanning in order to obtain clear images. When the examination is completed, you will be asked to wait for the technologist to verify that the images are of high enough quality for accurate interpretation. The scan usually takes about 10-15 minutes if the heart rate is slow and steady, but please allow 2 1/2 hours for pre-procedure preparations and post-procedure observation.

The beta-blocker medication given to slow the heart rate can cause some patients to feel dizzy when they stand suddenly after the procedure due to a lowering of blood pressure. Because of this, you will be asked to sit up slowly on the table prior to standing. The dizziness is typically mild and occurs rarely. You may also have your blood pressure taken before, during, and following the examination if medications are given.

After the scan has been completed, you will be able to return to your normal activities and your usual diet unless otherwise instructed.

For your safety and the protection of others, we do not allow anyone other than patients in our exam rooms.

How Do I Get the Results?

After your study, the images will be evaluated by one of our board-certified radiologists with expertise in cardiac imaging. A final report will be sent to your doctor or healthcare provider, who can then discuss the results with you in detail.

Reports are also available on the MyRAD Patient Portal

Cardiac Imaging Team

Shalini Guliani-Chabra, M.D.

  • Specialties:
    Body Imaging, General Radiology
  • Education:
    University of Mumbai, 1993
    M.D University of Mumbai, 1998
  • Internship:
    Internal Medicine, New York Medical College, 2002-2003
  • Residency:
    Diagnostic Radiology, University of Pittsburgh School of Medicine, 2004-2008
  • Fellowship:
    Diagnostic Radiology, University of Pittsburgh School of Medicine, 2008-2009
  • Board Certifications:
    ABR 2008

Shaun P. McManimon, M.D.

  • Specialties:
    General Radiology, Interventional Radiology
  • Education:
    B.S. – Boston University, 1983
    M.S. – University of Michigan, 1986
    M.D. – University of Michigan, 1988
  • Internship:
    General Surgery, Wilford Hall USAF Medical Center (San Antonio), 1989-1990
  • Residency:
    Diagnostic Radiology, St. Joseph’s Hospital and Medical Center (Phoenix), 1993-1997
  • Fellowship:
    Interventional Radiology, University of Colorado, 1997-1998
  • Board Certifications:
    ABR 1997; CAQ Interventional Radiology 1999, 2011

With Radiology Ltd. since 1998

Tamara F. Lundeen, M.D.

  • Specialties:
    Cardiothoracic Imaging, General Radiology, Molecular Imaging
  • Education:
    B.S. - University of Arizona, 2002
    M.S. - Duke University, 2007
    M.D. -University of Arizona, 2013
  • Internship:
    Medicine, University of Arizona, 2013-2014
  • Residency:
    Radiology, University of Arizona, 2014-2018
  • Fellowship:
    Nuclear Radiology, University of Arizona, 2017-2018
    Cardiothoracic Imaging, University of Arizona, 2018-2019
  • Board Certifications:
    ABR 2017

Meet Kimberly, Tucson native

Cardiac CTA is a minimally invasive test which enables radiologists to evaluate the coronary arteries. Many physicians advocate the Cardiac CTA exam for their patients with certain histories or symptoms.  CT scanners have rapidly advanced in recent years, allowing physicians like Kimberly’s to obtain crystal clear pictures of her heart even while it’s beating. The result – you can know your risk for heart disease at an even earlier stage.