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Cardiac computed tomography (CT) scanning is an advanced cardiac imaging technique that utilizes CT technology, with or without intravenous (IV) contrast, to produce accurate cross-sectional virtual slices of specific areas of the heart, coronary circulation, and major blood vessels such as the aorta, pulmonary veins, and arteries. The computer processes these slices to generate three-dimensional images. Multidetector CT (MDCT) is a rapid form of CT scanning that captures multiple slices...
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Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
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Calcium-Scoring CT ScanA calcium-scoring CT scan, also known as coronary artery calcium (CAC) scan, detects calcium deposits in the coronary arteries. This test assesses the risk of coronary artery disease (CAD), which can lead to cardiovascular events such as angina, heart failure, and sudden cardiac arrest.A calcium-scoring CT scan is generally recommended for individuals at intermediate risk of CAD without symptoms. It includes:Men aged 40-75 and women aged 50-75: Especially those with a...
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Coronary vasospasm during CT angiography.

Takehiro Nakahara1, Takuji Toyama2, Yoshito Tsushima3

  • 1Department of Medicine and Biological Science, Gunma University Graduate School of Medicine, 3-39-22 Showa, Maebashi, Gunma 371-8511, Japan.

Journal of Cardiovascular Computed Tomography
|July 29, 2014
PubMed
Summary

Vasospastic angina can be challenging to diagnose, even with cardiac CT. Beta-blockers, while common for CT, may mask symptoms of this condition in susceptible patients.

Keywords:
Asian patientsBeta-blockersCardiac CTLandiololRoutine useVasospastic angina

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Area of Science:

  • Cardiology
  • Diagnostic Imaging

Background:

  • Coronary artery disease diagnosis often involves cardiac CT.
  • Beta-blockers are frequently administered during cardiac CT procedures.
  • Vasospastic angina is a condition characterized by reversible coronary artery spasms.

Observation:

  • A 71-year-old male smoker presented with post-dinner chest oppression.
  • Cardiac CT with beta-blocker revealed coronary stenosis, but adenosine triphosphate-stress perfusion SPECT showed no ischemia.
  • Holter monitoring later detected ST elevation during symptomatic episodes while smoking.

Findings:

  • The patient was diagnosed with vasospastic angina.
  • Cardiac CT performed without a beta-blocker showed non-obstructive, diffuse plaque and negative remodeling.
  • Asian populations exhibit a higher prevalence of vasospastic angina.

Implications:

  • Routine beta-blocker use in cardiac CT may obscure the diagnosis of vasospastic angina.
  • Careful consideration of patient history and potential vasospastic angina is crucial.
  • Alternative diagnostic strategies may be necessary for patients at risk for vasospastic angina.