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What Tests Should Be Done To Assess Condition Of Heart Arteries?
Question: Dear doctor
Good day
My father underwent angioplasty in Feb-2013 and had 2 DES stents placed, one in LAD (90%)and the other in Ramus (99%). He was also diagonised with lesions in mid RCA, mid LAD and OMI all 50% in each.
We would like a further assessment to monitor his present arteries status and are caught up between Angiogram, CT Scan, Thyallium test.
Pls guide us with your wisdom considering his condition to go for which test and do what next.
He is non smoker, non drinker and pure veg aged 55 yrs and since angioplasty, has changed his complete eating. No oil in the food at all.
He is also on ecosprin, t.cl opid, atorvastin, ramipril, metoprolol.BP 135/80. Heart beat 60.
Good day
My father underwent angioplasty in Feb-2013 and had 2 DES stents placed, one in LAD (90%)and the other in Ramus (99%). He was also diagonised with lesions in mid RCA, mid LAD and OMI all 50% in each.
We would like a further assessment to monitor his present arteries status and are caught up between Angiogram, CT Scan, Thyallium test.
Pls guide us with your wisdom considering his condition to go for which test and do what next.
He is non smoker, non drinker and pure veg aged 55 yrs and since angioplasty, has changed his complete eating. No oil in the food at all.
He is also on ecosprin, t.cl opid, atorvastin, ramipril, metoprolol.BP 135/80. Heart beat 60.
Brief Answer:
Coronary angiogram vs. non-invasive cardiac imaging
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Contrast-Enhanced CT Angiography:
With the high temporal and spatial resolution of multislice spiral CT, accurate assessment of luminal narrowing in the major branches of the coronary arteries is possible in selected patients.The highest accuracy has been noted in the left main and the proximal portions of the left-sided coronary arteries with decreased sensitivities in the more distal segments and in the more rapidly moving right coronary artery.
Limitations of CT include its dependence on ionizing radiation and the need for iodinated contrast.The radiation doses for coronary CTA generally exceed those delivered during standard diagnostic cardiac catheterization(Angiogram).
Fast or irregular heart rhythms and body motion limit the accuracy of CTA. Heavy calcification and artifacts from stents preclude accurate assessment of the severity of a stenosis.
For the diagnosis of angiographically significant CAD, SPECT using 201T1 ( Thallium-201) has an average sensitivity of 87% and specificity of 73%.
Coronary angiogram remains the 'Golden test' though it is semi-invasive. However it is recommended in view of Multi-vessel diseases and double stenting. It will also delineate collateral blood vessels traversing from one vessel to the distal vasculature of a severely stenosed or totally occluded vessel.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Coronary angiogram vs. non-invasive cardiac imaging
Detailed Answer:
Hi,
Thank you for your query. I can understand your concerns.
Contrast-Enhanced CT Angiography:
With the high temporal and spatial resolution of multislice spiral CT, accurate assessment of luminal narrowing in the major branches of the coronary arteries is possible in selected patients.The highest accuracy has been noted in the left main and the proximal portions of the left-sided coronary arteries with decreased sensitivities in the more distal segments and in the more rapidly moving right coronary artery.
Limitations of CT include its dependence on ionizing radiation and the need for iodinated contrast.The radiation doses for coronary CTA generally exceed those delivered during standard diagnostic cardiac catheterization(Angiogram).
Fast or irregular heart rhythms and body motion limit the accuracy of CTA. Heavy calcification and artifacts from stents preclude accurate assessment of the severity of a stenosis.
For the diagnosis of angiographically significant CAD, SPECT using 201T1 ( Thallium-201) has an average sensitivity of 87% and specificity of 73%.
Coronary angiogram remains the 'Golden test' though it is semi-invasive. However it is recommended in view of Multi-vessel diseases and double stenting. It will also delineate collateral blood vessels traversing from one vessel to the distal vasculature of a severely stenosed or totally occluded vessel.
Regards
Dr. T.K. Biswas M.D. XXXXXXX
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Shanthi.E
Answered by
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