November 26, 2004
New Technique Helps Evaluate Heart Disease
Computed tomography of the coronary arteries (CT angiography of the heart) is a very new technique and, if done carefully, allows excellent visualization of the vessels that supply blood to the heart ("New scan technology lets doctors see heart," Nov. 17). We've now done 50 of these studies at Seattle Radiologists and there are several factors we believe the public should know. It's important that this study should be done only after consultation with one's personal physician or cardiologist.
Every year in the United States about 1.4 million invasive, expensive cardiac catheterizations are performed to evaluate for heart disease. This procedure involves, at a minimum, eight hours at the hospital. A catheter is threaded from the groin to the heart and X-ray pictures are taken while a special fluid is injected. This allows visualization of the arteries.
The study has certain defined risks but, in properly selected patients, the risks are justified. Some of the more significant risks include stroke (brain infarct) or damage to the arteries one is trying to image.
On average, 30 percent to 35 percent of these invasive heart catheterizations are normal. For that reason and others, properly selected patients may be better served by undergoing the new multi- detector CT heart scans, or CT angiography. This procedure allows a radiologist the same ability to visualize the coronary arteries but at a fraction of the cost of a conventional cardiac arteriogram and in much less time. The risks of stroke or damaged arteries are eliminated.
Patients who might be candidates for this procedure are ones who have what doctors refer to as "atypical" chest pain or other patients who have high risk factors for coronary artery disease. The United States is on the cusp of a heart disease explosion with the aging Baby Boomer population and the nationwide epidemic of obesity and diabetes. We believe the invaluable breakthrough of this new CT technology will enable faster, less expensive and less invasive diagnosis of the heart's diseased blood vessels.
It is a sobering statistic that sudden death is the first sign of heart disease in 150,000 Americans every year. Heart CT angiography scans have the potential to revolutionize detection and treatment of coronary artery disease. In fact, with this new relatively fast, low- risk procedure, patients may more readily and more quickly be directed to the proper medical, interventional or surgical therapy.
Nevertheless, we strongly emphasize that this new technology is not appropriate for all patients with proven or suspected coronary artery disease. In fact, appropriateness standards need to be established by the Colleges of Radiology and Cardiology to avoid unnecessary studies. Until that occurs, we urge patients to first seek a consultation with their personal physicians or cardiologists to thoroughly understand the risk, rewards, indications and costs.