High-Tech Scans Spot Heart Blockages
Sophisticated CT Scans May Help Avoid Unnecessary Procedures
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How Will Doctors Use CT Heart Scans?
"This is a very positive study in the sense it showed the effectiveness
of the 64-slice CT to identify people with coronary artery disease,"
Timothy Gardner, MD, tells WebMD. Gardner is an American Heart Association
spokesman and a heart surgeon at Christiana Care Health Services in Wilmington,
"The question that still remains is how it fit into the diagnostic
workup of the patient without adding an additional test along the way," he
Miller tells WebMD that the new scanners, which are four times faster than
traditional 16-slice CT scans, may be a good alternative to exercise
stress tests to look for coronary artery disease in some patients.
Exercise stress testing generally cannot safely be performed on a frail,
elderly person, she says.
Also, "this can be an additive test for people who have equivocal
results on a stress test but whose doctors don't think there is anything wrong.
Right now, they are referred for catheterization, but the CT scan could help
avoid that," Miller says.
CT Heart Scans' Limits
CT scans are not for everybody. They fail to produce good images in people
with a lot of calcium deposits in their artery plaque, Gardner says. Like
sludge in a drain, the calcium interferes with a clear picture.
In fact, people with a lot of calcium deposits -- who accounted for about
one in four of people originally recruited -- were excluded from the study.
Raymond J. Gibbons, MD, a past American Heart Association president and the
Arthur and Gladys D. Gray professor of medicine at the Mayo Clinic in
Rochester, Minn., tells WebMD that he's also concerned about cancer risks.
study published earlier this year showed that radiation from the scan may
increase lifetime cancer risk, particularly in younger women.
All the doctors stressed that CT scans should not be used to screen for
plaque in people who do not have
symptoms of coronary artery disease.
The CT scan, including the doctors' fee, costs about $1,000, according to
Gardner. Angiography carries a price tag of $2,500 and up, he says.
But angiography is generally covered by insurance, while Medicare and
other insurers are still evaluating whether to pay for the scans, Gardner
Toshiba, which makes the CT scanner used in the study, provided funding for