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Heart Tests Your Doctor May Recommend

Coronary Calcium (Ultrafast CT Scan)

An image of the heart is taken with a standard CT-scan machine in this test. It measures how much calcium has built up in the plaque in your arteries. There's a strong link between the amount of calcium in your arteries and having coronary heart disease, including how widespread the disease is.

Who should get it? Cardiologist Henry Patrick, MD, who practices in Baton Rouge, LA, says the test is useful for middle-aged people who have:

Patrick says he uses coronary artery calcium to decide:

  • Whether to start someone on aspirin and statins
  • Whether someone needs a screening stress test
  • When to schedule follow up visits

This test is not for people with known CAD.

Pros: It's inexpensive, painless (you lie in the scanner for about 10 minutes), and can be more informative than other tests.

Cons: Because the test can't see "soft plaque" that hasn't calcified, it may not be as useful when you've had sudden symptoms. While the test lets your doctor know the likelihood of CAD, it can't tell you how severe any blockages are. The only real risk is radiation exposure from the CT scan. Also, the test isn't covered by some insurance plans.

Heart CT Scan (Coronary CT Angiogram)

This test checks for blockages in the arteries that supply blood to the heart.

Steven G. Lloyd, MD, PhD, an associate professor of medicine and radiology at the University of Alabama at Birmingham School of Medicine, describes the test this way: You'll get a beta-blocker medication to slow your heart. Then dye, inserted into your arteries through an IV, helps to show any blockages while you have a standard CT scan.

Who should get it? The heart CT scan is only recommended for people who've had chest pain and who are being considered for other non-invasive procedures, such as a nuclear stress test. That test uses radioactive dye to show areas of the heart that aren't getting good blood flow.

Pros: A heart CT tells you whether you have any blockages and how serious they might be. It gives similar results to a coronary angiogram, but a heart CT doesn't require going inside the body. During a coronary angiogram, small tubes called catheters inject dye directly into the coronary arteries.

Cons: A heart CT uses more radiation than a CT scan, and the dye might harm your kidneys. Because it requires a certain machine, it isn't available everywhere. Your insurance plan may not cover the test.

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Reviewed on December 26, 2013

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