cardio-CT instead of cardiac catheter
The condition of the coronary arteries can only be determined with complete accuracy using a complex cardiac catheter examination. Up to now, if a disease of the heart and coronary arteries was suspected...
Until now, in cases where heart and coronary artery disease was suspected, a catheter was often inserted into an artery in the groin or wrist and advanced to the heart. However, this procedure is not without risk and is often an unnecessary burden for the patient.
However, a rough overview is often sufficient - this can be obtained with a special examination using cardio-computed tomography (cardio-CT). This is particularly recommended if there is an increased family history or other risk of heart attack.
Computed tomography is an imaging technique based on X-rays. In cardio CT, a rotating X-ray tube turns around the patient lying on an examination table so that the heart is imaged at high speed and in several layers at the same time. The computer then calculates three-dimensional images from the individual cross-sectional images.
A cardio-CT scan is used to determine coronary artery deposits and the condition of the coronary arteries.
To determine the presence of a relevant coronary artery disease (CHD), a calcium score (Agatston Score) can be determined using a native CT of the heart. In this CT examination without contrast medium, the amount of calcium in the coronary arteries is measured and the risk of coronary heart disease is calculated from this.
This value provides information about how healthy the coronary arteries are and how high the risk of Heart attack This involves determining calcifications in the vessels.
With the information obtained, it is possible to initiate appropriate treatment as early as possible and thus prevent heart damage and an impending heart attack. An acute heart attack is often the first symptom of coronary artery disease, but arteriosclerosis (hardening of the arteries) of the heart often progresses unnoticed for a long time and the risks are often not known to patients.
Deposits of lime and cholesterol lead to an increasing narrowing of the coronary arteries (coronary heart disease). If a vessel is then completely blocked, part of the heart muscle is cut off from the oxygen supply and a heart attack occurs.
Calcifications in the coronary arteries can be detected quite well using a computer tomography (CT). For a long time, however, the problem was that the heart was constantly moving. This meant that it was not possible to take sharp images. This has only been possible since fast-working CT machines were developed in the last ten years.
Determining the calcium content of the coronary arteries is an important prognostic test.
Today, computed tomography is of great importance in vascular ultrasound. An important element here is the measurement of calcium in the coronary arteries. Modern CT devices can also detect small calcifications without the use of contrast media. The amount of calcium can be determined for each of the three coronary vessels. An individual risk profile can be created based on age, gender and other risk factors, to develop relevant constrictions in later life, a heart attack or Stroke to suffer.
The advantages of the lime score determination are
- the gentle procedure - no surgical intervention is necessary
- It allows a risk assessment that is as good as that of a catheter examination.
- contrast medium administration is not necessary
If the calcium score is below 10, everything is fine
When determining the calcium score, no individual images of the heart vessels are taken, but a computer program calculates the total load of calcium deposits based on a relatively rough image. The examination is carried out on an outpatient basis and takes no longer than ten minutes.
If the calcium score is below 10, the calcification is very low. A calcium score of 100, on the other hand, already indicates moderate calcium deposits.
In one study, around 1000 men with an average age of 57 were observed for ten years after a calcium score measurement. If their score was below 10, the annual risk of a heart attack was 0,6%. If their calcium score was over 400, the risk was already 3,2% - five times higher. 54% of men over 65 have a value higher than 100.
If the calcium score is low, you can assume with almost 90% certainty that the risk of heart attack is also low, even if other risks, such as high cholesterol, exist.
On the other hand, it is difficult to estimate the risk of a heart attack when the calcium score is high. It simply indicates that you should do more to protect your heart, especially if coronary heart disease occurs frequently in the family or if there are other risk factors for a heart attack, such as high cholesterol levels, Hypertension, smoking, being overweight or Diabetes.