Chest pains, heart flutters and, of course, a heart attack are common signs of heart trouble. In the past, such symptoms might require a minimally invasive technique, such as cardiac catheterization, to diagnose the problem. However, innovative technology is quickly evolving imaging and testing methods.
Procedures such as cardiac CTA, coronary calcium scoring and cardiac MRI provide the Summa Health cardiac team with much of the same information as the more conventional tests, yet are significantly less invasive to the patient. What’s more, the procedures are easier to perform and often provide faster, more accurate results. However, should a patient need it, Summa Health cardiologists are also trained to perform minimally invasive techniques, such as diagnostic cardiac catheterizations. In addition to screening and determining cause, these procedures can also be used to monitor your heart and find out if your treatment is working.
Computed Tomography Angiography (CTA)
Often used as a diagnostic tool for early heart disease, a coronary CTA (CCTA) is a technique for finding small blockages in coronary arteries. With CCTA, the Summa Health cardiac team can view the structures of the heart and coronary arteries in any dimension, including a three-dimensional view. This allows us to rule in or out significant heart and artery disease, or congenital abnormalities. And we can see it in just a few minutes. What’s more, CCTA provides less radiation than nuclear stress testing, and often less than cardiac catheterization.The CT scanner is a large square machine with a circular hole, often described as looking like a donut, that links to the ECG. You will be asked to hold your breath and lie very still during the test. A contrast dye is injected into your arm as you lie on a sliding table. The CT scanner then rotates taking multiple highly detailed pictures or images (angiograms) of the coronary arteries of your beating heart. These arteries supply blood to the heart muscle, and disease of these vessels (atherosclerosis) is responsible for most heart attacks.
Summa Health’s state-of-the-art scanner can acquire the images of the entire heart in a single heartbeat in many patients. There is minimal risk with CCTA, and the results are over 95% accurate. It is often used in adjunct to structural heart and EP programs.
Cardiac MRI
A cardiac MRI provides unsurpassed quality in evaluating the heart’s shape, size, volume and function through moving 3-D imagery. While echocardiography or exercise stress tests have their own benefits, the MRI is much more comprehensive. It allows the Summa cardiac team to identify valve disease, heart muscle abnormalities, heart tumors and clots in the heart.
The MRI scan requires you to lay on a cushioned table inside the MRI tube. While no radiation is used, powerful magnets are used to create the images. Therefore, some patients may not be eligible. The MRI contrast may also cause allergic reactions, yet somewhat less frequently than a CT contrast. Be sure to discuss any concerns with your physician.
Coronary Artery Calcium Scoring
A coronary artery calcium scoring test is a screening often performed on patients who are not showing any signs or symptoms of an illness. The scan shows the amount of calcium in the walls of the arteries that supply the heart muscle. The more calcium, the higher the calcium score and the higher risk you may have of experiencing a heart attack or stroke in the next five to 10 years.
The amount of calcium in the walls of the arteries is measured by taking a special computed tomography (CT) scan of your heart. Electrode patches are placed on your chest so an electrocardiogram (ECG) machine can be attached. You then lie on a scanning table that moves through the CT machine’s round opening. The CT machine links to the ECG so that the recorded electric pulses from your heart notify the CT when to take the scans. You will be asked to hold your breath, the table will move and images of your heart will be taken. (As in all X-ray scans, radiation is used so this procedure should be avoided if you are pregnant or trying to conceive.)
Your Summa Health physician will use the coronary artery calcium score to determine if you are at high risk of heart issues and, if necessary, provide guidance.
Echocardiograms
An echocardiogram (also called an echo) is a type of ultrasound test that allows Summa Health cardiologists to observe the size and function of all the heart’s chambers, evaluate the valves and detect abnormalities. All by using high-frequency sound waves to create an image of the heart.
During an echocardiogram, a technician moves a hand-held device over your chest so images and sounds are produced. A device, called a transducer, picks up echoes of the sound waves as they bounce off the different parts of your heart. These echoes are turned into moving pictures of your heart that can be seen on a video screen. Your physician reviews the results of the test to determine if there are any abnormalities of the heart muscle or valves.
There are a variety of echo tests, including transthoracic echoes (TTE) and transesophageal (TEE) echoes, as well as special techniques like stain imaging and 3D. Echo testing is often adjunct to structural heart and EP programs.
All of Summa Health’s echo readers are board-certified and the Summa Health Heart and Vascular Institute's echocardiogram laboratory is accredited by the Intersocietal Accreditation Commission (IAC). This accreditation is indication that the Institute has proven a commitment to providing quality medical testing for our patients.
Stress Testing
Often ordered alongside imaging, stress tests can help detect conditions that are only apparent when the heart is stressed. During the test, sticky pads and wires (electrodes) are attached to your arms, legs and chest. The pads are connected to a computer that measures the electrical impulses that cause your heart to beat. Typically, you walk on a treadmill with the pace increasing slightly at regular intervals. Your electrocardiogram, blood pressure and heart rate are monitored closely as you exercise.
In addition to routine treadmill exercise, stress testing may include nuclear stress and stress echo options. Stress testing can also be performed using an infused medicine in patients who are unable to exercise on a treadmill.
You might need an imaging stress test if:
- You have symptoms of heart disease – such as chest pain, shortness of breath, irregular heartbeats or heart palpitations
- An electrocardiogram (ECG) shows something abnormal and your doctor can’t get useful information from a standard stress test
- You are at high risk of heart disease due to risk factors like smoking.
- You have health problems linked to heart disease, such as diabetes, high blood pressure or peripheral artery disease