Good or bad idea to get a cardio Cat Scan?

I had the Watchman implanted last January, and all looks good. No leaks or clots or any problems. I am staying on low dose Eliquis as a precaution, per conversation with Dr. Natale, Shannon and reading Carey's posts.

As I've had shortness of breath for over 6 years (started after I got walking pneumonia) but supposedly I also have Diastolic Dysfunction and high cholesterol (I've really been trying to avoid cholesterol meds...), my Cardiologist thought it would be a good idea for me to get a cardiac Cat Scan. (just a side note....Dr. Natale said that the LAA isolation might make it look like I have Diastolic Dysfunction when I may not....) Nonetheless, this would give us a better idea as to what's going on and also, if I have any significant blockages. I did suggest a Stress Test, but she thought this would be a better thing to do.

I am concerned as to the radiation from a Cat Scan, and also....are these a good idea? My sister had one done 5 years ago that said she had 50% blockages in her arteries, then had a angiogram this year and it said they were only 20%. The medical person who did the angiogram thought they were more accurate than the cat scan....

Anyone have insight on any of this?

Thanks ~ Barb

I believe there are many different kinds of cardiac CT scans.. with contrast .. without etc.. are you talking about a calcium CT scan? They are relatively low radiation (mammogram-ish), no contrast, cheap, and any doctor and prescribe. For me personally, I have stayed off cholesterol medicine for now even though my cholesterol isn't an A+, because of the cardiac CT and other diagnostic tests. I even plugged the score into some risk indicators on .. I think it is called Mesa. [www.mesa-nhlbi.org]

If you are talking about something else then .. IDK.

Assuming they're using a modern CT scanner, the radiation dose is pretty minimal. I wouldn't be concerned with just one scan.

A stress-echo would reveal anything major and show if you needed to investigate a possible blockage further, but she might want to see the lungs too since shortness of breath is your chief complaint and it began after a bout of pneumonia. Makes sense to me.

An angiogram is the gold standard for detecting and measuring blockages, but a CT scan is a quick way to decide if you need one. Angiograms also involve radiation, injection of a contrast agent that adds more, and carries higher risks than a CT. I would do the CT.

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just a side note....Dr. Natale said that the LAA isolation might make it look like I have Diastolic Dysfunction when I may not....)

Yep, that happened to me. I discovered that someone (haven't figured out who) added that to my chart incorrectly as a diagnosis some time after my Natale ablation. It got me rejected for a life insurance policy.

I often wonder if the medication I was given for the walking pneumonia may have caused my shortness of breath issue.....can't remember the name of it now, but I believe it's one that can also cause ankle or foot problems...? Anyway, I'm not sure if a cardio cat scan will also look at the lungs...hoping it will. This scan will also do a calcium score, which I believe gives a good indication on how much plaque or blockage I might have.

At this point, I'm scheduled for next week. Really hoping this will be it for heart stuff....already have high BP (controlled well now), and this breath thing, along with the 10 years of Afib I had. Just hope I'm not opening a can of worms by having this done, but as my sister said, it could also uncover something that could have been an issue and now that it's identified, won't be.

Carey..did you have shortness of breath too? I also have mild pulmonary hypertension...it's on the border and has gotten a bit better, but my Cardio isn't concerned about it really. Apparently I have the kind that isn't so bad...

OK...time for sleep! Thanks for your input Carey and Bettylou. I'll look up that link you sent for scoring too...BArb

Anxiety will produce unwanted side effects, so anything you can do to calm yourself, to be optimistic, and to let the various diagnoses, in the order they are prescribed by the experts looking after your best interests, take place and to reveal what they might, is the best prescription for you right now.

I had all the conceivable tests, including MIBI (twice now, with no apparent problems except that when I maxed out on the treadmill I had a brief burst of supreventricular tach). I had an MRI, numerous chest X-rays, and finally an angiogram. As Carey points out, the latter is the definitive test, but it's invasive where the others are not, and there's always a risk of heart attack and stroke when they insert the catheter to send the dye into your cardiac veins. So, they do it last when the other tests don't seem to reveal any particular worries.

Remember, even today, with all the diagnostic tools at the disposal of car dealership repair persons, the first step is to raise the hood and see what's what. First things first, and the CT scan is a reasonable first stab at figuring out what's going on.

Yes, a cardiac CT will show your lungs. It will show everything in your chest -- heart, lungs, aorta, esophagus, etc. You should ask the lab that does the CT to give you the images. They're pretty cool to look at.

No, I did not experience shortness of breath. If you have pulmonary hypertension, that could be the cause of your shortness of breath.

In my case, I had a "Chest" CT Angiogram with Contrast about a year ago. It focused very thoroughly on the lungs and respiratory system. There wasn't a ton of cardiac information but did show the heart silhouette.

I've also had a CT Angiogram Coronary Arteries with Contrast last May to look at blockages (as there's a familial history). This test focused very heavily on the heart and plumbing but not so much on the lungs. The benefit to this test was it obviously looked at the coronary arteries, but also gave an update on structural heart properties, chamber sizes, filling and pumping volume, EF, etc. It was like getting parts of a cardiac MRI and Echo in addition to thoroughly looking at the coronary artery health. This was a pretty quick test and usually done before an Angiography with catheter as that is more invasive, however usually more accurate.

I've also had a Cardiac MRI with Contrast last January. Some view this as the gold standard to look at heart scarring/damage, infiltrative processes and can be prescribed with varying focus depending upon the doctor's wishes as it's a pretty lengthy test.

For me, the CT Coronary Angiogram was worth getting because I can now realize whether blocked arteries are a factor in symptoms I've dealt with since getting AFib (and it appears they are not).

Thank you all for your replies. I appreciate the support and calming words, "gloaming" (I am curious if that's your name or means something else..)

The Nurse Practioner told me I would be getting nitroglycerin right before they start the scan to get a better look at the arteries (Yikes...that sounds scary), and that the test is only about 15 minutes. At any rate, it looks like I'm doing it and keeping my fingers crossed that if there's anything to find, it has a simple solution.

I'm guessing most people have something less than optimal regarding their heart once they hit their 60's....would really like to just be DONE with heart related issues. But it is what it is.

Happy Wednesday ~ Barb

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tobherd
The Nurse Practioner told me I would be getting nitroglycerin right before they start the scan to get a better look at the arteries (Yikes...that sounds scary)

Not scary—it is simply a vasodilator (relaxes the blood vessels) so they can get a better look. Sublingual nitroglycerin is a very common treatment for angina. No worries!

As part of my yr from hell lol. March 2021 i had a contrast ct prior to my flutter ablation. It failed so i went to Austin. Dr Natale too did a CT! 2 in 6 months. Im 69 so im banking on out living the radiation. 2 ct s and 2 ablations in 6 months. Whata ya gonna do? My flutter has been zero so its a good trade

I’d hate to say how many CTs and other scans I’ve had. Suffice to say I believe I glow in the dark . But I’m still alive and kicking.

Yes, I think I heard that the radiation from a Cat Scan shouldn't create a problem for at least 20 years, if at all. I figure I will be close to 90 then, and hoping to outlive any issues too!

Glad you are alive and kicking, JoyWin. Tom....wasn't thinking of radiation for an ablation...naive question, but is it?

BArb

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tobherd
Tom....wasn't thinking of radiation for an ablation...naive question, but is it?
BArb

Most ablations use fluoroscopy, which is a continuous x-ray, like an x-ray video as compared to an x-ray photo. If you ask for your ablation report it should document how many minutes of fluoroscopy you received and what the total radiation dose was. It's still minimal enough that it's generally nothing to worry about, but it does contribute to your lifetime total.

I've had 5 chest CTs and 6 rounds of fluoroscopy, but the radiation dose doesn't concern me. Airline pilots and flight attendants probably receive more in one year than I've received from all those CTs and fluoroscopies.

If it helps, I have had two MIBI tests. They required the equivalent dose of 500 chest X-rays. I'm still hale and hearty. Or so I think.

Strange reading this thread. I had a head injury yesterday and today I was dizzy nauseous and had a headache so I went tonight (abroad at 7pm) to an urgent care by taxi. They sent me away saying I need to be in the hospital so they told me to take another taxi to the town limits, and then call for an ambulance because the urgent care was out of the jurisdiction of ambulances. Went on a bumpy fast ambulance on mountainous roads to a hospital known for head trauma. Three spoke English. Waiting for a second visit from a young neurologist. Luckily I knew today’s date and other questions.

I just had a ct scan and read joy’s post. Joy -I win the number of lifetime ct scans.

Having a watchman is a good thing. Today’s Eliquis half dose got me symptomatic. With a watchman I can stop Eliquis for a few days. I skipped tonight dose.