Dr. Adey Agbetoyin explains the Coronary CTA, a cardiac-imaging technique, to a patient.

Cardiac imaging diagnoses heart disease

A relatively new cardiac imaging technique in the Jackson area is giving doctors a clearer picture of the heart, allowing them to better diagnose and manage heart disease, says Dr. Adey Agbetoyin, a Jackson cardiologist.

Coronary Computed Tomography Angiogram (Coronary CTA) is a heart-imaging test to determine whether fatty or calcium deposits have built up in the coronary arteries, which supply blood to the heart muscle. These areas of build-up, or plaques, can lead to heart muscle disease if untreated and can result in fatigue, shortness of breath, chest pain or a heart attack, Dr. Adey explained.

Dr. Adey, a founding member of the Society of Cardiovascular CT, has been credentialed by Jackson-Madison County General Hospital to perform and interpret this exciting new imaging technique for the heart.

“Oprah actually had one of these procedures done on herself for her show,” says Dr. Adey, who practices at The Cardiovascular Clinic of West Tennessee. “The test is simple and takes about 15 minutes to complete. It is highly effective in the early detection of heart disease. One big plus to the patient is that the test is non-invasive, and recent scientific data indicates CCTA has the same diagnostic accuracy as the more invasive cardiac catheterization procedure in selected patients.”

Although a cardiologist orders the test, the actual CT scan is performed by a technician either in the physician’s office, an outpatient center or at the hospital on an outpatient basis, he explained.

During the test, the patient is given medication to slow the heart rate to about 60-65 beats a minute and then receives an iodine-containing contrast dye through an intravenous (IV) line to ensure the best possible image. The results are a 3D image of the patient’s heart, which the physician views on a computer screen to identify the coronary arteries and determine if there is any plaque present in their walls.

This technologically advanced heart CT scan is highly effective as a means to rule out significant narrowing of the major coronary arteries, Dr. Adey says. It also can non-invasively detect “soft plaque,” or fatty matter in the artery walls that represents the earliest stage of coronary disease, which can then be treated with medication and lifestyle modification.

Dr. Adey says the test, which has a high negative predictive value, is very accurate in the early detection of heart disease and, for some patients, the test either rules out or confirms the disease.

The Coronary CTA also can be used by the cardiologist to visualize stents and heart by-pass grafts in patients to determine whether they are still open or have become clogged. This type of test keeps the patient from undergoing invasive procedures, such as a cardiac catheterization, which can have a higher risk, as well as being inconvenient to the patient, says Dr. Adey. The test also can be used to diagnose congenital coronary anomalies.

As with any test that utilizes x-ray equipment, the risk versus the benefit of increased exposure to radiation must be weighed, determined, and discussed by the patient and his or her physician, he added.

“The test is not for everyone and is definitely not a screening tool for coronary heart disease predicators.” Men less than 35 years of age and women younger than 40 are not likely to gain much benefit from this test unless there are risk factors, such as diabetes or a strong family history of heart disease.

“This new test can be a powerful diagnostic tool for any patient with typical or atypical symptoms, and for women, those can be very different than a man’s symptoms,” says Dr. Adey. “Of course, if you think you are having a heart attack, you should not wait, but go immediately to an emergency room for evaluation.”