Introduction #

CT Coronary Angiography (CTCA) is a special type of CT scan that focuses on the coronary arteries, the blood vessels that supply the heart muscle. Using X-rays and contrast dye, CTCA produces detailed pictures that help doctors detect narrowing, blockages, and calcium buildup (plaque) in the arteries.

It is widely used to evaluate chest pain and to rule out or confirm coronary artery disease (CAD) without the need for invasive procedures.

Common Indications for CTCA #

Your doctor may request a CTCA to:

• Investigate chest pain or shortness of breath

• Detect or rule out coronary artery disease (CAD)

• Measure calcium buildup (plaque) in the coronary arteries

• Check stents or bypass grafts

• Assess heart risk before surgery or major treatment

• Evaluate suspected congenital abnormalities of the coronary vessels

What does a CT scanner look like? #

The scanner looks like a large, doughnut-shaped machine. You’ll lie on a moving table that passes through the scanner while images of your heart’s blood vessels are taken.

What happens during a CTCA procedure? #

• You’ll lie flat on your back.

• ECG leads will be attached to your chest to monitor your heart rate.

• For clear images, your heart rate usually needs to be steady and below 60–65 beats per minute. If it’s higher, you may be asked to relax a bit more and the ECG repeated, or meet with your doctor on  how best to lower your pulse rate.

• A contrast dye will be injected through a vein in your arm to make your coronary arteries visible

• You’ll be asked to hold your breath briefly while the scanner takes images.

Do I need to prepare for a CTCA? #

Yes. Preparation is important for accurate results:

• Avoid eating or drinking for 4–6 hours before the scan. Small sips of water are usually allowed.

• Avoid tea, coffee, chocolate, and energy drinks for 12–24 hours before the scan.

• Wear comfortable clothes; you may need to change into a hospital gown.

• Take your usual medicines unless instructed otherwise. 

Do I need a kidney test before the scan? #

Yes, since contrast dye is used, your radiographer may request a creatinine blood test to check kidney function.

How long does a CTCA scan take? #

The scan itself will take about 10 – 15 minutes. With preparation (IV line, ECG leads), the entire visit may take 30–60 minutes.

Is CTCA safe? #

Yes, it is generally safe. However:

• There is some radiation exposure, though kept as low as possible.

• Contrast dye is safe for most people but can rarely cause allergic reactions or affect the kidneys.

• Inform your radiographer if you have asthma, kidney disease, or previous reactions to contrast.

How is CTCA different from a conventional coronary angiogram? #

• CTCA: Non-invasive, uses a CT scanner and contrast dye, good for diagnosis and ruling out disease.

• Conventional angiogram: Invasive, uses a catheter inserted through the wrist or groin, allows both diagnosis and treatment (e.g., stent placement) in the same procedure.

Conclusion #

CT Coronary Angiography is a safe, accurate, and non-invasive way to examine the blood vessels of the heart. It plays a key role in diagnosing or ruling out coronary artery disease and helps doctors plan the best treatment to protect your heart health.