Introductory Guide to Cardiac CT Imaging by Ragavendra R. Baliga MD MBA FRCP FACC

By Ragavendra R. Baliga MD MBA FRCP FACC

This guide deals citizens, fellows, and working towards physicians a good creation to cardiac CT imaging and CT angiography. It comprises chapters on coronary CT angiography, CT angiography of the peripheral arteries, and cardiac CT from the point of view of the interventionalist, the electrophysiologist, and the cardiac health care provider. The booklet provides the most recent details at the symptoms for and obstacles of CT and covers using CT for particular stipulations comparable to peripheral vascular affliction and congenital middle sickness. A bankruptcy on easy methods to manage a cardiac CT lab is additionally incorporated. Appendices contain info at the significant gadget manufacturers.

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Indd 36 9/10/09 5:31:16 PM CHAPTER 3 | How to Perform Cardiac CT Angiography: Dos and Donts 37 2. The limitations of coronary CT are related to patient size, volume of coronary artery calcium, heart rate and rhythm, use of iodinated contrast, and exposure to radiation. 3. If patients exceed the body mass index threshold of 35 to 40 kg per m2, other clinical options should be considered, as patient exposure to radiation and contrast may not result in diagnostic-quality images. 4. Patients deemed high risk by Framingham or Reynolds risk scores, or those with high volumes of coronary calcium by prior testing, such as a preceding electron-beam CT, should have their coronary arteries evaluated by means other than CCTA.

PRACTICAL POINTS 1. The strength of coronary CT lies in excluding obstructive coronary artery disease in the symptomatic, intermediate-risk patient. indd 36 9/10/09 5:31:16 PM CHAPTER 3 | How to Perform Cardiac CT Angiography: Dos and Donts 37 2. The limitations of coronary CT are related to patient size, volume of coronary artery calcium, heart rate and rhythm, use of iodinated contrast, and exposure to radiation. 3. If patients exceed the body mass index threshold of 35 to 40 kg per m2, other clinical options should be considered, as patient exposure to radiation and contrast may not result in diagnostic-quality images.

Blockers are usually used to maintain the heart rate between 60 and 70 beats per minute. 8. Although there is no specific number that would prompt a physician to cancel the contrast portion of a scan, it would be reasonable to consider cancellation in any patient with a calcium score of 500 or greater (either Agatston or volumetric), especially in a single-vessel territory. indd 37 9/10/09 5:31:16 PM 38 Introductory Guide to Cardiac CT Imaging ADDITIONAL READING 1. Halliburton SS, Abbara S. Practical tips and tricks in cardiovascular computed tomography: patient preparation for optimization of cardiovascular CT data acquisition.

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