Heart Disease Screening with Calcium Scoring and Coronary CT Angiography (CTA) at Stamford Hospital

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1 Heart Disease Screening with Calcium Scoring and Coronary CT Angiography (CTA) at Stamford Hospital

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3 Calcium Scoring and CT Angiography (CTA) can help determine whether heart disease is present, even in its earliest stages before any symptoms. With the information screenings your doctor can help you reduce the risk of a heart attack.

4 Heart Disease Screening Heart disease is the number one killer of men and women in the United States. An estimated 2 million Americans will have a heart attack each year. Many people have no symptoms and don t realize their health is in jeopardy. Fortunately, new tests have been developed which can help identify those of us at risk. Lifestyle changes, medication and, in some cases, surgical intervention, can reduce the risk of heart disease and enable most people to lead long, healthy lives. Coronary artery disease (CAD) is the most common form of serious heart disease. CAD is the end result of a progressive narrowing of the arteries due to the presence of plaque (atherosclerosis). Plaque is made of cholesterol, fibrous tissue and calcium. Plaque can clog arteries and prevent oxygen-rich blood from reaching the heart. It can appear years before the development of symptoms, such as chest pain or shortness of breath, and can cause a heart attack without warning. Stamford Hospital now offers two state-of-the-art medical tests that provide a convenient, painless and non-invasive way to screen for heart disease. 1

5 What is Calcium Scoring? Calcium Scoring detects the presence of calcium in the walls of your arteries, which can help predict heart disease. Computed Tomography (CT) is used to take a series of images of your heart and coronary arteries. The result of this test is a calcium score and a risk assessment that is based upon the calcium score. The score tells you whether you fall into a low, medium or high risk of heart disease. The presence of any calcium tells you the process of atherosclerosis is already taking place. The amount of calcium guides your physician regarding further evaluation and preventive treatment. The test is easy, quick and comfortable, requiring no special preparation, dye injections or fasting. CT Calcium Scoring does require radiation exposure. What is Coronary CTA? Coronary CTA can detect the presence and severity of blood vessel narrowing by providing detailed images of blood flow in the coronary arteries. For this type of test, contrast dye is injected into a vein to visualize the coronary arteries and other structures, such as the heart chambers and large vessels that carry blood in and out of the heart. A Computed Tomography (CT) machine generates a series of threedimensional images that are reviewed by a specially trained radiologist and/or cardiologist. Coronary CTA is a safe, quick and non-invasive way to test for heart disease. The test does require radiation exposure and injection of contrast (or dye ) into an arm vein. Because there is preparation involved you will need your primary care physician or cardiologist to schedule this appointment by calling People with significant kidney disease may not be good candidates for CTA. stamfordhospital.org For more information, please call WELL (9355) 2

6 How do I know if heart screening is right for me? You should consider heart screening with Calcium Scoring and Coronary CTA if you are a man between the ages of 35 and 70, or a woman between the ages of 40 and 70, with any of the following risk factors: n Family history of early heart disease n Smoking n Diabetes n Elevated cholesterol n High blood pressure n Overweight n Sedentary lifestyle n Uncontrolled stress n Postmenopausal woman (and without estrogen replacement therapy) Your primary care physician or cardiologist can help you determine if you are a candidate for heart screening with CTA. Together, you and your physician can review your medical history, family history and risk factors for heart disease. If you would like to get a referral to a Stamford Hospital primary care physician or cardiologist, please call us toll-free, 24 hours a day, at WELL (9355). We ll help find the right doctor for you. 3

7 What is special about heart screening at Stamford Hospital? Both Calcium Scoring and Coronary CTA are performed with our new Aquilion 64 CFX Computed Tomography (CT) machine, the most sophisticated CT scanner currently available. The CT scanner rotates X-ray beams around the body, capturing ultra-thin images of the heart and coronary arteries. These images are reconstructed by a computer, which produces exquisitely detailed, three-dimensional pictures. You can have the Calcium Scoring test and the Coronary CTA at the same time at Stamford Hospital. If you are having both tests you must arrive 1 hour prior to the exam, which takes about 30 minutes. Stamford Hospital s board certified radiology and cardiology staff will interpret the study and the results discussed with your physician. stamfordhospital.org For more information, please call WELL (9355) 4

8 How do I prepare for the tests? The Calcium Scoring test does not usually require preparation beforehand and there are no specific instructions regarding exercise, food intake or medications. Patients with a rapid resting heart rate (above 80) may require medication to lower their heart rate for the test. If you are having the Coronary CTA, your physician will give you instructions including any necessary blood work required prior to the exam, prescriptions and test preparation requirements. You can have your blood work done at our Patient Testing Center at the Tully Health Center, Your physician may prescribe a beta-blocker to ensure that your heart rate is below 65 during the procedure. This medication will be taken at home. If you have an allergy or sensitivity to contrast dye or shellfish you may be given an additional medication. Before you have the Coronary CTA it is important to closely follow these preparatory instructions: n Do not exercise the day before the test. n Do not have anything by mouth at least four hours prior to the test. n Do not consume anything containing caffeine (including decaf coffee, tea or soda) 12 hours before the test. n Take your usual daily medications, unless otherwise advised by your doctor. However, you should not take any erectile dysfunction medications such as Viagra, Levitra or Cialis for 48 hours before the test. n Your doctor may prescribe a beta-blocker to lower your heart rate and other medications if you are sensitivity to the contrast agent. Please follow the exact instructions for taking these medications. n Women should avoid wearing a bra with an under wire (hooks for closing in the front or back are not a problem). n Jewelry (including personal piercings) should be removed at home. 5

9 What happens during the tests? Upon arrival, you will be asked to change into a gown. If you are only having the Calcium Scoring test, you will be asked to lie flat on a comfortable table with a wedge beneath your knees. While holding your breath, the CT scanning machine will take a series of images of your heart. This will take approximately 20 seconds. The test is painless and, in most cases, the entire procedure should be completed in about 15 minutes. If you are also having a Coronary CTA, you will have an IV (a small catheter) inserted into your arm. A Registered Nurse will monitor your blood pressure and heart rate throughout the test. Four sets of images will be taken and you will be asked to hold your breath for 10 to 20 seconds for each set. The final set of images will be obtained with the contrast agent. This may cause you to feel a warm flush all over your body, but the feeling will pass quickly. The entire procedure should be completed within 30 minutes. The physician in charge may choose to give you medicine during the test to lower your heart rate (beta blocker) or dilate blood vessels, to produce better quality images. stamfordhospital.org For more information, please call WELL (9355) 6

10 What happens after the tests? Please drink plenty of clear fluids after the Coronary CTA test. This will help flush the contrast agent from your body. You are free to go home and continue your usual activities, with no restrictions. How will I get my results? Once the tests are complete, a board-certified radiologist and/or cardiologist will evaluate your results and forward a report to your physician. Your physician can use the results from these tests to evaluate whether your risk of heart disease is high enough to warrant taking more aggressive preventive action. Your physician may recommend other tests based on the evaluation. 7

11 Scheduling Information You must have a prescription from your primary care physician or cardiologist in order to take the Calcium Scoring test. You can schedule the test by calling the Central Scheduling Office at Your physician s office must order the Coronary CTA by contacting the Central Scheduling Office. A scheduling nurse will make all of the arrangements and contact you to explain the testing procedure to you by telephone. Payment Information Most major health plans including Medicare DO NOT cover these tests at the present time. We will contact your insurance company to determine if the procedure is covered. Payment is due at the time of your tests, after you check in with the Patient Registration Service, located on the first floor of the hospital. Many convenient payment options are available, including most major credit cards. For more information about payment procedures, please contact the Patient Registration Service at For More Information For more information visit our website at or call us at We will be happy to answer any questions you may have. stamfordhospital.org For more information, please call WELL (9355) 8

12 Stamford Hospital 30 Shelburne Road P.O. Box 9317 Stamford, CT