Understanding Coronary CT Angiography (October 2023)
Growing up around conversations of heart disease and hyperlipidemia (high cholesterol), I have tried to educate myself professionally and personally about lab tests, noninvasive tests and nutritional recommendations for cardiovascular disease. Not only did I hear about all of my family members having heart disease and lipid issues when I was still a child, but I was told when I was only 13 years old that I myself had elevated cholesterol.
One of the reasons I decided to enter the field of dietetics was because my dad had coronary artery disease (CAD). When he unexpectedly passed away 14 years ago at age 68, I decided to have noninvasive tests on my heart every five years.
People often assume that registered dietitian nutritionists (RDNs) follow health-conscious diets. There is certainly some stigma in making that assumption. However, based on my family history of CAD, I have been mindful of my diet, but I have also chosen to live my life with food pleasure via dining out, traveling and being curious when grocery shopping.
When I had my physical at the end of 2022, I had discussed with my internist whether it would be wise— based on my family history, my own medical history and the fact that I’m getting older—to have the most comprehensive tests done in order to look for soft and hard plaque buildup in my arteries.
Even though I knew it was important for me to have these tests, I felt some ambivalence, because I know it’s only a matter of time until I need to go on a statin (medication to reduce plaque and improve one’s lipid panel).
Because of my experience, I want everyone to know about coronary CT angiography. This is a noninvasive test that uses computed tomography (CT) to look at the vessels that supply blood to your heart muscle. This test allows your doctor to see whether plaque has developed in your coronary arteries. If it has, this could lead to blockages, which could cause symptoms and increase your chance of having a heart attack.
The test is noninvasive because it uses a series of x-rays and a computer to obtain 3D images. The radiologist or imaging tech also does an electrocardiogram by attaching sticky patches (electrodes) to your chest. The electrodes connect to a machine that measures and records your heart rhythm during the coronary CT angiography examination so that the x-ray images can be matched with the motion of your heart. Before the coronary CT angiography, you’re injected with contrast dye (often iodine-based) so your coronary arteries are visible on the images. Some people experience a warm sensation when the dye is injected. I experienced that, as well as a headache from the nitroglycerin that was sprayed under my tongue. That lasts about 15 minutes.
I would suggest asking your doctor if, based on your family and personal medical history, this test is appropriate for you. I am glad that I asked those questions, and will have it done again in five years.