CT Coronary Angiography: Test, Cost, Report and Comparison

CT Coronary Angiography

Treatment Duration

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20 Minutes

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30 Minutes

Treatment Cost

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10,000

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25,000

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CT Coronary Angiography

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The World Health Organisation reports that one-fifth of all heart-related fatalities occur in India. This highlights the need to have more advanced methods to diagnose and treat cardiovascular diseases. CT coronary angiography test is one such innovative technique that has surfaced in recent years.

This non-invasive imaging approach has rapidly gained prominence. In this blog post, we'll cover everything about it, including CT coronary angiography report interpretation.

Procedure Name

Computed Tomography Coronary Angiography

Alternative Name

Cardiac CT or Coronary CTA (CCTA)

Conditions Diagnosed

Coronary Artery Disease (CAD)

Benefits of Procedure

  1. Non-invasive visualisation of coronary arteries

  2. Detection of blockages

  3. Assessment of heart health

Treated By

Cardiologists or Radiologists

You can check CT Coronary Angiography Cost here.

What is CT coronary angiography?

Computed Tomography (CT) coronary angiography is a diagnostic imaging technique that visualises the coronary arteries. These are the blood vessels (arteries) that supply oxygen and nutrients to the heart muscles.

Unlike conventional coronary angiography, which involves threading a catheter through blood vessels to inject contrast dye, CTCA relies on advanced technology.

Anatomy of the Heart

The human heart is a remarkable organ situated in the thoracic cavity between the lungs. It plays a primary role in the circulatory system. 

  1. Chambers: The heart has four chambers – two atria (upper chambers) and two ventricles (lower chambers).

  2. Septum: It divides the heart into left and right sides. This ensures that oxygenated and deoxygenated blood do not mix.

  3. Valves: Four valves control blood flow: 

    1. The tricuspid and mitral valves are between the atria and ventricles.
    2. The pulmonary and aortic valves lead to the lungs and the rest of the body.
  1. Coronary Arteries: These vessels supply the heart muscles with oxygen and nutrients.

Physiology of the Heart

The heart goes through a synchronised series of events known as the cardiac cycle. It ensures the continuous flow of oxygen and nutrients to all the organs.

  1. Blood Flow: Here are the steps for better understanding:

  1. Deoxygenated blood returns to the right atrium.
  2. It moves to the right ventricle.
  3. Pumped to the lungs for oxygenation.
  4. Oxygenated blood returns to the left atrium.
  5. It moves to the left ventricle.
  6. Pumped into the entire body through the aorta (largest blood vessel carrying oxygen-rich blood).
  1. Cardiac Cycle: The heart undergoes a series of contractions (systole) and relaxations (diastole) during each heartbeat.

  2. Conduction System: Electrical signals coordinate heart contractions. The sinoatrial (SA) node initiates the signal, followed by the atrioventricular (AV) node.

  3. Blood Pressure: The force of blood against the arterial walls. Systolic pressure is during contraction, and diastolic pressure is during rest.

  4. Cardiac Output: The amount of blood the heart pumps per minute.

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Conditions Diagnosed with CT Coronary Angiography

CT coronary angiography test can help diagnose various cardiovascular conditions. It presents detailed images of the coronary arteries and the heart. 

  1. Coronary Artery Disease (CAD)

  1. Detection of Atherosclerosis: Visualisation of fatty plaques or atherosclerotic lesions within the coronary arteries.
  2. Assessment of Stenosis: Evaluation of the degree of narrowing or blockage in the coronary arteries.
  1. Coronary Artery Anomalies: The examination assists in the detection of congenital variations in the structure of arteries.

  2. Aneurysms: It can detect irregular bulges or dilation in blood vessels.

  3. Vascular Abnormalities: The test helps check the structure and integrity of blood vessels, identifying any deformities.

  4. Pulmonary Embolism: It can be used to identify blood clots or emboli in the pulmonary arteries.

Who needs a CT coronary angiography?

CT coronary angiography test can be recommended for individuals with specific clinical indications or risk factors. Healthcare providers may consider CTCA for the following:

  1. Individuals experiencing persistent chest pain or discomfort.

  2. People going through unexplained shortness of breath.

  3. A person with risk factors such as hypertension, diabetes, high cholesterol, obesity and smoking.

  4. Individuals with a history of heart conditions, such as a heart attack.

  5. Whose echocardiogram (ECG) shows abnormalities in heart function or structure.

  6. Patients who have undergone coronary artery bypass graft (CABG) surgery.

Benefits of CT Coronary Angiography

CT coronary angiography test offers several advantages as a diagnostic imaging tool. Some of them are:

  1. Non-invasiveness, eliminating the need for catheterisation and reducing associated risks.

  2. Provides high-resolution images, offering detailed visualisation of coronary arteries.

  3. Relatively quick, taking less than an hour, which leads to faster diagnosis.

  4. Offers a comprehensive assessment of coronary artery disease (CAD) as well as information about heart chambers and valves.

  5. Assists in risk stratification by providing details about the extent and severity of coronary artery disease.

  6. Enables early detection of atherosclerosis, plaque buildup, and other cardiac abnormalities.

  7. Applicable to a wide range of patients, including those with chest pain and suspected CAD.

CT Coronary Angiography Test Procedure

The actual CT coronary angiography test itself may only take a few seconds to minutes. However, considering the setup time and other preparations, the entire CTCA procedure typically lasts around an hour.

  1. Preparation: The patient may receive a numbing medication. This helps minimise discomfort during the injection process.

  2. Electrode Placement: The technician attaches sticky patches (electrodes) to the patient's chest. They are connected to a machine that records the heart rate and rhythm. This information is crucial for synchronising the imaging with the cardiac cycle.

  3. Patient Positioning: The patient lies on their back on a table that smoothly goes into a machine named a CT scanner. 

  4. Contrast Dye Injection: It enhances the visibility of blood vessels during the procedure. 

  5. Breath-Holding Instructions: During the CT scan, the patient may be instructed to hold their breath for short intervals. This is to reduce chest movement, ensuring sharper images.

  6. Image Acquisition: The CT scanner takes a series of X-ray images. They are processed by specialised software to create detailed cross-sectional views of the coronary arteries.

Before and On the Day of CT Coronary Angiography

Following the guidelines before and on the day of the CT coronary angiography is essential. This helps the healthcare team to ensure a smooth and successful imaging procedure. 

Before CT Coronary Angiography

Prior to undergoing a CT coronary angiography test, patients are advised to follow pre-procedural instructions. The patient is instructed to fast for four hours before the procedure. However, they can take water as usual.

Here’s what they can expect:

Parameter 

Pre-Requisites

Pre-op Assessment

  1. Blood tests

  2. Medical history

Risk Evaluation

  1. Allergies

  2. Procedural risk

Anaesthesia Selection

No anaesthesia

Fasting

4 hours of fasting

No caffeine or stimulants before the procedure

On the Day of CT Coronary Angiography

On the day of the CTCA, patients arrive at the imaging centre. After the necessary registration process, they are explained about the procedure.

All metal objects, including eyeglasses, jewellery, or dentures, must be removed. The individual must inform the doctor if they have metal implants like a pacemaker.

Parameter

Pre-requisites

Consent

Mandatory

Surgical Preparation

  1. Removal of metal objects

  2. Hospital gown

  3. Briefing of procedure

Physical Evaluation

Observation of vitals (heart rate, blood pressure, oxygen saturation, etc.)

IV Line

Intravenous (IV) line for the administration of contrast dye

Anaesthesia Administration

No anaesthesia (sedation may be considered for patients with anxiety or claustrophobia)

After CT Coronary Angiography and Recovery

The recovery process involves observation for any adverse reactions. The healthcare facility ensures that the patient is stable before discharge. Here’s what you can expect:

The Recovery Process in Hospital 

Following a CT coronary angiography test, patients are monitored for a short duration to ensure there are no immediate complications. 

  1. Immediate Post: Procedure Monitoring: Vital signs such as heart rate and blood pressure are assessed to ensure the patient's stability.

  2. Care Instructions: Patients receive specific guidelines, which may include staying hydrated and any restrictions on medications.

Recovery Process/Expectation After Hospital Discharge 

These follow-up measures are crucial in ensuring a comprehensive approach to cardiovascular health. Patients can anticipate these once discharged:

  1. Normal Activities Resumption: Individuals are usually encouraged to restart daily work, including office and exercise. 

  2. Adequate Hydration: It is often recommended to flush out the contrast dye from the system.

  3. Long-term Monitoring: Patients are advised to be vigilant for any signs or symptoms. This may include allergic reactions, excessive bleeding, or persistent pain.

First Follow-up Appointment

The first checkup after CT coronary angiography is important for reviewing the results and discussing any identified issues. It helps to plan further in managing the patient's cardiovascular health.

  1. Report Assessment: The specialist discusses the CTCA findings with the patient. They explain any identified coronary artery disease, blockages, or other cardiac conditions.

  2. Treatment Planning: If any issues are detected, the healthcare provider discusses a customised plan. This may involve lifestyle modifications, medications or interventional procedures.

  3. Continuous Observation: A plan for ongoing monitoring and follow-up is established. This takes into account the patient's specific health needs and any detected cardiovascular conditions.

CT Coronary Angiography Test Report Interpretation

Interpreting a CT coronary angiography report involves understanding the detailed information provided by the imaging study. Here are key aspects:

  1. Coronary Artery Assessment: Evaluate the presence of atherosclerosis or plaque buildup in the coronary arteries. It also Identifies the degree of stenosis (narrowing), indicating the severity of blockages.

  2. Calcium Scoring: Assess the calcium score CT coronary angiography to quantify the amount of calcified plaque in the coronary arteries.

  3. Vessel Anatomy: Examine anomalies, irregularities, or aneurysms.

  4. Plaque Characteristics: Consider the nature of the detected plaque. This includes composition (calcified, non-calcified, or mixed), which may impact the risk of future cardiovascular events.

Below is a simplified table outlining normal versus abnormal interpretations of a CT coronary angiography test.

Aspect of CTCA Interpretation

Normal Findings

Abnormal Findings

Coronary Arteries

Clear, no plaque or stenosis.

Presence of atherosclerosis, plaque, or significant stenosis.

Calcium Scoring

Low calcium score, indicating minimal calcified plaque

High calcium score, suggesting a higher burden of calcified plaque

Vessel Anatomy

Absence of anomalies

Anomalies, or aneurysms

Plaque Characteristics

Minimal or non-significant plaque

Characteristics such as calcified, non-calcified, or mixed plaque

Extracardiac Findings

No major extracardiac findings.

Incidental findings like lung nodules or other abnormalities

Overall Impression

No considerable coronary artery disease, CT angiography normal report.

Presence of notable coronary artery disease or other cardiac abnormalities.

Risks and Complications of CT Coronary Angiography

While CT coronary angiography is generally considered safe, it is essential to be aware of potential risks and complications. Here are major points to consider:

  1. Radiation Exposure: This may carry a small risk of cancer. It can particularly happen in cases when individuals are undergoing multiple imaging studies. However, modern CT scanners often use dose-reduction techniques to minimise the danger.

  2. Allergic Reactions: Some patients may experience a reaction to the contrast dye injected during the procedure. This can range from a mild immune response like a rash to severe, life-threatening anaphylaxis.

  3. Claustrophobia: The need to lie still in an enclosed space during the CT scan may cause discomfort and anxiety in some individuals.

  4. False Negatives: Despite its high accuracy, CTCA may occasionally produce false-negative results. A significant coronary artery disease might get missed, especially in the presence of heavily calcified or motion-distorted vessels.

When to consult a doctor?

While CT coronary angiography is generally considered safe, there are situations where it's important to consult a qualified professional. Signs to seek medical attention include:

  1. Allergic reactions (rash, itching, or more) after contrast dye injection.

  2. Severe chest pain or discomfort.

  3. Persistent shortness of breath.

  4. Unexplained swelling or pain at the injection site.

  5. Severe headache or neurological symptoms.

  6. Irregular heartbeat or palpitations.

Risks of Delaying CT Coronary Angiography

Prompt diagnosis and intervention are crucial in managing cardiovascular conditions. Delaying CT coronary angiography when it is medically indicated can pose risks:

  1. Progression of coronary artery disease.

  2. Increased risk of heart attack.

  3. Delayed diagnosis of significant blockages or stenosis in coronary arteries.

  4. Reduced effectiveness of timely treatment strategies.

  5. Higher probability of worsened cardiac function and heart failure.

Cost of CT Coronary Angiography

The CT coronary angiography price can vary significantly based on various elements. The overview is given below.

CT Coronary Angiography

Estimated Cost

Maximum

₹ 10,000

Minimum

₹ 17,000

Factors that may affect the cost of CT coronary angiography include:

  1. Geographic Variation: Medical expenses may differ based on the country, region, or even within different cities.

  2. Healthcare Facility: Private hospitals, clinics, and imaging centres may have different pricing structures.

  3. Inclusion of Additional Services: The cost may include fees for the CT scan, interpretation of results by a radiologist or cardiologist, and more.

  4. Insurance Coverage: This can significantly influence out-of-pocket expenses. Some plans cover CTCA partially or in full. On the other hand, others may require copayments or have specific criteria.

  5. Pre-Procedure Consultation: If an appointment with a cardiologist is required, it may add to the final CT coronary angiography test price.

  6. Follow-Up Visits: Review checkups for report discussions and further treatment plans may contribute to the total expense.

Takeaway

CT coronary angiography test emerges as a valuable diagnostic tool. It offers a non-invasive means of assessing coronary arteries and identifying cardiovascular issues. The ability to provide high-resolution images highlights its significance in shaping proactive cardiac care.

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Frequently Asked Questions (FAQ)

CT Coronary Angiography (CTCA) is a non-invasive medical imaging technique. It utilises computed tomography technology to produce detailed cross-sectional images of the coronary arteries.

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CT Coronary Angiography (CTCA) is recommended for its effectiveness in providing detailed images of the coronary arteries. It aids in the diagnosis of coronary artery disease (CAD) and in assessing the severity of blockages or abnormalities.

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CT coronary angiography is indicated for individuals with suspected coronary artery disease (CAD). It is recommended for those experiencing chest pain to visualise and assess the degree of blockages.

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CTCA differs from traditional angiography in that it is a non-invasive imaging technique that uses X-ray technology. The conventional method involves threading a catheter through blood vessels. CTCA provides detailed cross-sectional images of the heart's blood vessels.

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CT coronary angiography offers significant benefits in cardiovascular diagnostics, providing non-invasive, high-resolution images. With the ability to detect early signs of coronary artery disease, CTCA plays a crucial role in timely diagnosis.

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While CTCA is generally considered safe, it involves exposure to radiation. This may pose a small risk, particularly in individuals undergoing multiple scans. Additionally, there is a potential for allergic reactions to the contrast dye.

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Yes, CTCA is generally considered a safe procedure when performed by qualified healthcare professionals. The benefits of accurate cardiovascular assessment often outweigh the minimal risks associated with the test.

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CT coronary angiography is conducted by injecting a contrast dye to enhance blood vessel visibility. The patient then lies on a table that moves into a CT scanner. It captures detailed X-ray images from multiple angles to create cross-sectional views of the coronary arteries.

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Before undergoing CTCA, individuals typically need to follow specific preparations. This may include:

  1. Fasting for a few hours before the procedure.

  2. Avoid caffeine and certain medications.

  3. Informing healthcare providers about allergies.

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No, sedation is typically not used during CTCA. The procedure is generally well-tolerated, and patients remain conscious and alert throughout.

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The duration of a CTCA procedure typically takes about 30 minutes. The actual scan may only take a few seconds. However, accounting for other preparations is generally completed within the given timeframe.

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The turnaround time for receiving CT coronary angiogram results can vary but is generally relatively quick. In many cases, patients can anticipate the results within a few days.

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To read and interpret a CT coronary angiography test report, one should focus on key elements, such as:

  1. Presence of atherosclerosis

  2. Degree of stenosis

  3. Calcium scoring

  4. Vessel anatomy

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Upon receiving the results of a CT coronary angiography, treatment options may include:

  1. Lifestyle modifications

  2. Medication management

  3. Interventional procedures such as angioplasty

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While CTCA provides detailed images of coronary arteries, it is a diagnostic procedure and does not involve interventions.  If significant blockages are identified during the test, an angioplasty is typically performed.

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To choose a qualified doctor for CTCA, consider these:

  1. Seek recommendations from your primary care physician.

  2. Look for professionals with relevant certifications.

  3. Experience in cardiac imaging.

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Recovery after CTCA is typically swift, with most individuals able to restart their normal activities immediately. Patients generally experience no downtime.

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CTCA is typically performed in specialised medical imaging facilities within hospitals or dedicated outpatient imaging centres. These facilities are equipped with advanced CT scanners.

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Yes, CTCA is not limited to detecting coronary artery disease alone. It can also provide valuable insights into various other heart conditions. This technique allows for the assessment of heart valves and congenital anomalies.

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CTCA is typically not recommended as a routine monitoring tool. It is often used for initial diagnosis or in specific situations. The frequency of CTCA is determined on a case-by-case basis.

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Generally, there are no specific dietary restrictions after CTCA. Patients are usually free to resume their regular diet unless otherwise advised by the doctor.

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Yes, in most cases, individuals can resume normal activities immediately after CT coronary angiography. The procedure is generally well-tolerated, and there is no need for extended recovery or downtime.

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Insurance coverage for CT coronary angiography varies depending on the policy and provider. Many plans do cover a portion or the full cost of CTCA. However, individuals are advised to check with their company to understand specific details.

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The average expense for CTCA procedure is ₹ 13,000. It ranges from ₹ 10,000 to ₹ 17,000. It is essential to consider that there are several cost-influencing factors, like the type of medical facility, cardiologist’s experience and expertise, location, among many others.

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Yes, CT scans can show stents in the coronary arteries as they are metallic devices. This allows healthcare professionals to assess their placement, patency, and potential complications.

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A CT angiogram can provide valuable information about the presence and extent of coronary artery disease. It is a common underlying cause of angina.

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CT angiography is considered a valuable alternative to conventional angiography. This is because it offers a non-invasive approach, eliminating the need for catheter insertion.

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References

All the articles on HexaHealth are supported by verified medically-recognized sources such as; peer-reviewed academic research papers, research institutions, and medical journals. Our medical reviewers also check references of the articles to prioritize accuracy and relevance. Refer to our detailed editorial policy for more information.


  1. Sreeniwas Kumar A, Sinha N. Cardiovascular disease in India: A 360 degree overview. Medical Journal, Armed Forces India [Internet]. 2020 Jan 1;76(1):1–3.link
  2. Arbab-Zadeh A. Coronary Computed Tomography Angiography (CCTA) [Internet]. www.hopkinsmedicine.org.link
  3. Coronary Computed Tomography Angiogram | Cleveland Clinic [Internet]. Cleveland Clinic. 2019.link
  4. Mayo Clinic. CT coronary angiogram - Mayo Clinic [Internet]. Mayoclinic.org. 2017.link
  5. Computed Tomography Angiogram (CT Angiogram) [Internet]. myhealth.alberta.ca.link
  6. Karlo CA, Leschka S, Stolzmann P, Glaser-Gallion N, Wildermuth S, Alkadhi H. A systematic approach for analysis, interpretation, and reporting of coronary CTA studies. Insights into Imaging. 2012 May 1;3(3):215–28.link
  7. Radiology (ACR) RS of NA (RSNA) and AC of. CT Angiography (CTA) [Internet]. Radiologyinfo.org. [cited 2024 Jan 31].link
  8. CT angiography [Internet]. www.healthywa.wa.gov.au.link
  9. Computed Tomography Angiography (CTA) [Internet]. www.hopkinsmedicine.org. 2019.link
  10. Heart: Anatomy and Function [Internet]. Cleveland Clinic. 2021.link

Reviewer

Dr. Bikram Kesharee Mohanty

Dr. Bikram Kesharee Mohanty

MBBS, MS General Surgery, DNB Cardiothoracic and Vascular Surgery

31 Years Experience

Dr Bikram Kesharee Mohanty is a well-known Cardiothoracic and Vascular Surgeon currently associated with the Sitaram Bhartia Institute of Science and Research and National Heart Institute, New Delhi.

He has 31 years...View More

Author

Sparshi Srivastava

Sparshi Srivastava

B.Tech Biotechnology (Bansal Institute of Engineering and Technology, Lucknow)

2 Years Experience

An ardent reader, graduated in B.Tech Biotechnology. She was previously associated with medical sciences secondary research and writing. With a keen interest and curiosity-driven approach, she has been able to cont...View More

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