Screening for Coronary Artery Disease

Cardiac CT angiography is an imaging test that looks at the heart and its surrounding blood vessels. This painless, noninvasive test shows blockages and narrowing of the arteries that increase heart attack risk.

CT angiography helps doctors treat heart disease and determine if current treatments are effective. In some cases, this test may prevent the need for more invasive tests. Data gathered from the CT exam helps cardiologists determine if a patient may need cholesterol-lowering drugs called statins and if other medicines or lifestyle changes are recommended to reduce the risk for heart attack or stroke.

At UChicago Medicine, our cardiologists use the new GE Revolution CT scanner for all heart CT scans. This powerful imaging technology provides sharp, 3-D images of the heart at the lowest possible radiation dose. The machine can cover the entire heart in one spin and can provide detailed images even when the heart is beating rapidly or irregularly.

A dye called a contrast agent is typically given through an IV during the scan. This dye allows physicians to follow blood flow as it travels through blood vessels and the heart.

Cardiac CT angiography is helpful in assessing a wide range of heart conditions, including coronary artery disease, diseases of the aorta and other structural heart problems. It is particularly helpful in patients who have had an inconclusive stress test, but it may also be used to help surgeons, interventional cardiologists, and electrophysiologists to plan and perform complex heart procedures such as TAVR and Mitraclip.

Our team of cardiac imaging experts is highly skilled at determining which heart tests are appropriate for each patient. Some instances when cardiac CT may be recommended include the following:

  • Chest pain and/or suspected coronary artery disease. Cardiac CT angiography can be used as a noninvasive way to determine if chest pain is due to the blockages or narrowing of the coronary arteries.
  • Inconclusive stress test. If data gathered from a stress test is inconclusive, physicians may recommend a cardiac CT to look for coronary artery disease or other problems.
  • Presence of other heart disease symptoms. Like the symptom of chest pain, people who exhibit other symptoms of heart disease, such as shortness of breath, neck, jaw, back or arm pain may be candidates for CT angiography.

Diagnosing Coronary Artery Disease

Accurately diagnosing coronary artery disease is critical to deciding the most effective treatment; many factors play into identifying a diagnosis. Symptoms such as chest pain and shortness of breath are indicators of the disease but can sometimes be attributed to other, unrelated problems. Some people may experience no symptoms at all.

Because coronary artery disease varies from person to person, our cardiologists perform thorough examinations and order tests to confirm the diagnosis and evaluate the extent of the disease.

At UChicago Medicine, our team can choose from several types of tests to determine if a person has coronary artery disease. These tests include the following and more:

ECGs are painless tests that record the electrical activity of the heart. They can also reveal damage to heart tissue caused by a heart attack. We offer all types of ECGs, including 24-hour Holter monitoring, which involves wearing a portable heart monitor to assess heart function throughout the day.

Echocardiograms are painless tests that use sound waves to create a picture of the heart. UChicago Medicine cardiologists can perform 3-D echocardiography, an advanced imaging technique.

Stress tests are performed to show how your heart reacts to exertion. These tests are often done while you are on a treadmill or exercise bike. People who cannot exercise may receive a non-exercise stress test, which uses a medication that helps mimic the effects of exercise. Stress tests are performed with or without ECGs or noninvasive imaging methods such as echocardiography or nuclear imaging tests.

Nuclear tests involve the use of a small amount of a “tracer” substance that is injected into a vein. A special camera detects the tracer to create images of the heart that help physicians determine damage to the heart's muscle or decreased blood supply to a particular portion.

UChicago Medicine is home to Chicago's first 256-slice CT scanner, a powerful machine that can provide incredibly clear, cross-sectional images of the heart and its coronary arteries. These noninvasive tests help doctors diagnose disease and may reduce the need for more invasive tests.

Cardiac catheterizations are tests — including angiograms — that involve the use of thin tubes (catheters) to inject a safe dye into the heart and blood vessels supplying the heart. This dye can be seen with an X-ray. The test helps physicians assess the pumping function of the heart and the blood supply to it. During these procedures, physicians often insert special wires to assess blood flow within the heart.

Like angiography, intravascular ultrasound is a test performed with the use of a catheter. This procedure uses a specially-equipped catheter that emits sound waves to create a picture of the inside of the artery. This advanced test helps physicians assess the structure of the arteries and that of the blockage inside it. Intravascular ultrasound is not widely available at most hospitals.