CORONARY CT ANGIOGRAPHY
What is Coronary CT Angiography?
Coronary CTA is an imaging procedure that uses CT technology to visualize blood flow in the
coronary arteries, as well as the major vessels going to and coming from the heart. A Coronary
CTA scan has the ability to recognize signs of heart disease that would be invisible in stress
testing, EKG's and even cardiac catheterization. Because Coronary CTA uses CT scanning instead
of catherization, it is performed more quickly, comfortably, affordably, and safely than
traditional coronary angiography, while still offering similar images to those provided by
invasive heart catherization.
What makes Coronary CT Angiography unique?
Radioactive imaging provides physicians a noninvasive way to differentiate between functional
and nonfunctional heart tissue. Coronary CTA scans visually isolate the heart by removing
surrounding structures to expose the signs of disease through 3-D visualization of coronary
arteries, calcified and/or soft plaque, heart chambers, and stents. The major advantage of
a coronary CTA is the ability to visualize soft plaque, which would otherwise be undetectable
during an electrocardiograph, stress testing, cardiac scoring, and even cardiac catheterization.
The examination is minimally invasive requiring no sedation or hospital stay.
How Coronary CT Angiography work?
Coronary CTA provides much of the same information that a conventional cardiac catheterization
does, but with reduced risks. The development of 16-detector row scanners has improved the
performance of the Coronary CTA. During the examination, the rotating CT scanner spins
around the patient, creating a beam of x-rays, and the detector takes snapshots of the
beam after it passes through the patient. The scan takes approximately 15 minutes allowing
for set up time.
What are the benefits of Coronary CT Angiography work?
The major advantage of a Coronary CTA is the ability to visualize soft plaque, which would
otherwise be undetectable during an electrocardiograph, stress testing, cardiac scoring,
and even cardiac catheterization. It is these soft plaques, which are most likely the
cause of heart attacks and sudden death.
Am I a candidate for Coronary CT Angiography?
You should discuss whether this test is appropriate for you with your physician.
The candidates for Coronary CTA include several patient groups. It is commonly used to screen
asymptomatic patients who have a recognized cardiac risk factor such as heart disease, diabetes,
high cholesterol, hypertension, or a history of smoking. Additionally, it is used to evaluate
symptomatic patients with atypical chest pain and are of intermediate risk for coronary artery disease.
What is the process to get scheduled for a Coronary CT Angiography?
Please call our Patient Services Department at (206) 292-7734 and request to speak with a
specialist who will review your medical history, medication, allergies and laboratory results.
It may be necessary to obtain medical records if you have had coronary procedures done in the
past. You will be given instructions about any necessary preparations prior to coming in
for your Coronary CTA.
SPECIAL PROCEDURES (Myelogram, Arthrogram, Spine & Joint Injections)
MYELOGRAM
What is a Myelogram?
A myelogram is an X-ray study in which contrast is injected into the spinal canal. Injecting
this contrast outlines the spinal cord and nerves, making them visible to the radiologist.
The injection may be done in the lower back or neck area.
When you arrive, our nurse will show you to our recovery room. Our nurse will assist you
in filling out a medical history form and then you will be asked to put on a gown. You will then
be escorted to the procedure room where you will lie on an X-ray table with a pillow under your
stomach. The radiologist, with the technologist's assistance, will then use antiseptic
to cleanse a small area over your lower back or neck. They will use local anesthetic to numb
the area and inject contrast. After the contrast is injected, the needle will be removed and
the radiologist will take several X-rays.
After the radiologist has finished, the technologist will take further X-rays to complete your
exam. You will then be helped onto a stretcher and taken to the recovery room to relax. After
a brief period, a technologist will take you for a CT scan. You will then be returned to the
recovery room where our nurse will monitor you for a total of three hours. You will be asked
to lie flat on your back with your head elevated slightly. The reason for this is because the
contrast that was injected can cause a headache if it gets into your head. Fortunately, the
contrast, which is water-based, is quickly absorbed by the bloodstream and eliminated through
the kidneys. By lying quietly and resting, you will help the clotting process. It is important
you rest for the remainder of the day. In fact, we recommend that you rest for the remainder of the day in a recumbent position (for lumbar myelograms) or an upright position (for cervical myelogram with approach via the neck).
Please allow three hours for this exam.
Patient Preparation for Myelograms
If you have not already spoken to one of our nurses, please contact them at (206) 292-8525. They will clearly explain the procedure and answer any questions you might have. If there is a chance that you may be pregnant, you must tell the nurse.
It is important to hold any strong blood-thinning medications for 72 hours (ASA, Coumadin, Plavix, etc.) and hold NSAIDS and other anti-inflammatories (Advil, Motrin, Naprosyn, Aleve) for 48 hours. Please ask our nurse if you are not sure. Also, there are certain medications such as anti-depressants and anti-psychotics that must be held. Please discuss your medication list with our nurse to be certain. If you are allergic to iodine or contrast dye, please tell the nurse so that pre-medication can be arranged.
Do not drink caffeine 24 hours before your exam. This includes chocolate, coffee, tea, some sodas and decaffeinated drinks. Do not eat any solid food after midnight before your exam. Clear liquids are acceptable. Please do not hold any blood pressure medications!
Drink plenty of clear fluids the morning of the exam up to two hours before your arrival time. This will decrease the possibility of a headache.
Please bring any prior relevant X-rays, CT's or MRI scans to your appointment. The radiologist will want to review those before your exam. You should also bring your insurance documents for the receptionist.
You must have someone with you to drive you home following your test. This needs to be prearranged in advance of your scheduled appointment.
After the Procedure
It is important to rest after the myelogram. Remain in a flat or reclined position at home until the next morning. This will prevent a spinal headache. Anticoagulants/ASA and NSIADS may be resumed the day after the procedure.
LUMBAR PUNCTURE
What is a Lumbar Puncture?
A lumbar puncture is done by our radiologist. Under fluoroscopy, the radiologist will remove
spinal fluid for analysis and diagnostic purposes. You will be prepped for the injection while
lying on your stomach. The injection site will be anesthetized and a small needle will be
inserted to remove the spinal fluid for testing.
Please allow 2 1/2 hours for this exam.
Patient Preparation for Lumbar Punctures
If you have not already spoken to one of our nurses, please contact them at (206) 292-8525.
They will clearly explain the procedure and answer any questions you might have. If there
is a chance that you may be pregnant, you must tell the nurse.
It is important to not take any blood-thinning medications for 72 hrs for strong blood thinning agents
(ASA, Coumadin, Plavix, etc.) and 48 hours for NSAIDS and other anti-inflammatories (Advil, Motrin,
Naprosyn, Aleve). Please ask our nurse if you are not sure. If you are allergic
to iodine or contrast dye, please tell the nurse so that pre-medication can be arranged.
In some cases, you may be required to have your blood drawn prior to the procedure.
Drink plenty of clear fluids the morning of the exam up to two hours before your arrival time. This will decrease the possibility of a headache.
Please bring your insurance documents for the receptionist.
You must have someone with you to drive you home following your test. This needs to be prearranged in advance of your scheduled appointment.
After the Procedure
It is important to rest after the lumbar puncture. Remain in a flat or reclined position at home until the next morning. This will prevent a spinal headache. Anticoagulants/ASA and NSIADS may be resumed the day after the procedure.
ARTHROGRAM / JOINT INJECTION
What is an Arthrogram / Joint Injection?
An Arthrogram is a fluoroscopic examination of a joint under fluoroscopy. The joint contains
soft tissue structures, including the cartilage and joint capsule. These are not visualized
on regular X-rays. An injection of X-ray contrast and air are used to coat and outline these structures.
During the exam, the Radiologist will clean the affected area with antiseptic soap. The injection site
is numbed and a needle is placed into the joint. The contrast or air are sometimes injected and the
needle is removed. A series of X-rays are then taken in a variety of positions. In some cases a CT or
MRI scan is requested to follow the arthrogram. If so, this will be done following the injection.
Please allow 1 1/2 hours for this exam.
Patient Preparation for Arthrograms / Joint Injections
If you have not already spoken to one of our nurses, please contact them at (206) 292-8525. They will clearly explain the procedure and answer any questions you might have. If you are allergic to iodine or contrast dye, please tell the nurse so that pre-medication can be arranged.
There are no restrictions on aspirin or any blood-thinning agents for an arthrogram or joint injection.
You do not need a driver.
After the Procedure
The contrast or air will be circulated out of the body within 24 hours after the injection. As
after-effects are very minimal, daily activities usually can be resumed. However, please refrain
from heavy lifting until the next day.
JOINT ASPIRATION:
If you are having an aspiration of a joint, please follow restrictions for blood thinning agents (strong blood thinners – hold for 72 hours; NSAID’s hold for 48 hours). Aspirations otherwise follow the same instructions as a joint injection detailed above.
EPIDURALS / NERVE ROOT BLOCKS / FACET INJECTIONS / JOINT ASPIRATIONS
Patient Preparation for Epidurals / Nerve Root Blocks / Facet Injections / Joint Aspirations
If you have not already spoken to one of our nurses, please contact them at (206) 292-8525. They will clearly explain the procedure and answer any questions you might have. If there is a chance that you may be pregnant, you must tell the nurse.
It is important to not take any blood-thinning medications for 72 hrs for strong blood thinning agents (ASA, Coumadin, Plavix, etc.) and 48 hours for NSAIDS and other anti-inflammatories (Advil, Motrin, Naprosyn, Aleve). Please ask our nurse if you are not sure. If you are allergic to iodine or contrast dye, please tell the nurse so that pre-medication can be arranged.
Please bring any prior relevant X-rays, CT scan or MRI scans to your appointment. The radiologist will want to review them before your exam. You should also bring your insurance documents for the receptionist.
I Am Ready to Schedule My Appointment.
With your physician's referral, please call (206) 292-7734 to schedule your exam.
