Why a CT Calcium Score is useful but often not enough
I had a CTCA scan when I worked abroad and was experiencing angina occasionally when exercising.
I do agree with your point of involving patients with own scan images & results. The one thing I recall about the scan was the warm flush felt when the contrast liquid was released. While seeing images of calcification in my own heart was a shock for me it was also a big part in turning a corner and reinforcing the health and nutrition choices I needed to make
Following stenting 7 years (... and 20kg ago!) I have had no chest pains since and manage my exercise goals on a weekly basis and in way a weekly exercise . Even though it was a while ago it is always the images of the plaque that I remember first as a reinforcement to prioritise my health.
Thanks for your highly readable articles, they are such a help to people like myself who wish to remain healthy following heart issues 🙏
Quality info Paddy. Interesting detail on plaque characteristics and specificity of imaging. Was contemplating a CAC but this has changed my perspective and cost is not prohibitive.
Love !! Your topics ! So valuable !
Dear Dr. Paddy,
I appreciated your article greatly. I have never found someone explain the advantages of CTCA so cogently and in such a simple language.
You have probably never heard of us. We are a world record holding CT Scan & MRI scan group with a 512-slice CT Scan & 3 Nos 128-slice CT Scan based Rajasthan, India. In the past 11 years, we have helped more than 2+ million and their doctors with high-quality CT Scan & MRI Scans. We are a low-cost high-volume operational efficiency model. We do a CTCA in 2 modes(based on a USD:INR of 1:84)
Mode A: Payment basis: $48 (Govt. keeps $26.5 and pays us $21.5)
Mode B: Below-poverty line/Government Referral: $21.5
Since India is the cardiac capital of the world, we have recently been working with the doctors for screening many patients. We have received a lot of push-back from cardiologists in the city. They feel we are eating into their bread & butter[CAG on Cathlab]. Nevertheless, we have persisted and last year we were shocked to find CAD-RAD 1 or higher (this was a sampling only) in ~40% cases ~1000 patients.
We would love to discuss with you over VC (VideoCall/Google Meet/Zoom etc.).
mohit.soni_____[at the rate]_____sonihospitals.com
You are greatly to be appreciated ! Thank you for your work and sharing it so cogently !
Like you, I worry that CTCAs in people without angina will often lead to unnecessary stents - high cost and risk. CT CAC might be enough if purpose is to encourage lifestyle change and make decisions about statins and BP drugs. Perhaps restrict CTCA to people with CT CAC < 100?
I did not read CTA of the coronary arteries but read all other CTAs. A lot of calcified plaque in the arteries can make estimation of the degree of stenosis difficult.