64 slice ct heart scan

Quick history, ablation for rentry svt in 2000, at that time it was discovered that I have bicuspid aortic valve with insuffinciency. I now do yearly echo's which show slight changes but not enough to do anything about. Over the past 5 year I have experienced chest pain on and off. Recently the pain was much worse than before so my cardio ordered a MIBI stress test which was normal except for shadows from what he felt was breast tissue. Since the pain did not go away and does get better with Nitro he sent me for further testing. I had a large lipoma removed from my left ribcage last Nov. so he felt the new 64 slice ct heart scan would be more revealing. I had it done Fri. morning and recieved a call around noon that it showed "major blockage in one of the major arteries to the heart" I was ro return and get a cathaterization done. I got to the  hospital to late to have it done on Fri. so I was admitted and treated as if I indeed had a blockage. I was put on heperin, integrital,altace, lopressor,plavix,zocor, and asperin and admitted into CCU. Monday morning when I was cathed, the doctor looked and showed me the area where the blockage was suposed to be and said it looked fine. Great news although I was perplexed that until this point no one ever mentioned that the ct scan could be wrong. The Dr. called over to the CT people and they orderd him to go back in and do a internal echo of the artery which also was fine. Question what could the ct scan have seen that looked like a blockage? How often are these scans wrong? Dr. mentioned spasms could this be a possibility?

[Cleveland Clinic]

mbimom,

Thanks for the post.

Spasms probably wouldnt be imaged on the CT scan.  The best thing to equate a cardiac CT scan to is a stress test. Just like stress testing, a cardiac CT scan is a method to noninvasively screen for coronary disease but the gold standard is still a cardiac catherization.  Like a stress test, several things can lead to artifact or false positive CT scans such as motion and calcium.  

The good news is you didnt have any significant blockages, unfortunately you needed a cath to show it. Get on with your health and incorporate all of the lifestyle modifications you can to prevent significant blockages from forming in the future.

good luck!

[mbimom]

Sorry this was so long winded I ran out of space. I didn't mention that I am 45 female non smoker,average wieght, low cholesteral, non diabetic. I did have historectomy 2 yrs ago and am on HRT. I still have the pain and it keeps me up all night. I will see the cardio next week. I did get up last night and did the nitro spray because the pain was so bad and it did work. I do have to say the one thing I did get out of this is that when I get the pain now knowing that it is definatly not a heart attack the stress of having the pain is gone. I did not mention either I have had a full workup for esophogus problems all negative. Thanks for your thoughts.  Terri

[EchoTech]

Indeed, there is not any test out there that is 100% correct all the time nor is there any test that is rid of false positives, which was what you had.  This is why they do multiple tests to either reconfirm a diagnosis or to explore other options. I hope this helps a little bit.

[mbimom]

Thanks for your thoughts. I was just so shocked when the cath was negative because I kept asking the nurses and doc's in CCU if it could be wrong and they would say "oh I don't think this million dollar machine would make a mistake" I guess it is a new machine and they said it was the only one on the east coast. I am on long island and was at North shore community hospital in Manhasset. Dr. Lee who did the cath told me that the ct see inside and outside the arteries and what it percieved as a blockage inside the artery could be something on the outside of the artery. He mentioned fatty deposits. What would your thoughts on this be? I am going to see my cardio next week He wants to look at the actual pictures, right now he only has the report. I still am having the pain but it is resolved with the nitro spray. Thanks for any thoughts you could add.  Terri

[blessed09]

I had the CT scan done as well. I scored a 755 on the test which meant that I had blockage in one or more arteries. My Doctor immediately ordered a catherization. Actually he gave me choice. According to him, "you could walk aorund and eventually have a heart attack and die or get a hearth catherization". Guess what I chose?  Anyways, the catherization, like yours, came back normal. In fact the doctor said my arteries "looked fantastic and smooth". My wife asked him again and he said everything was great. I asked about the CT test along with the nurse and the doctor just nodded his head. It seems like half the doctors are sold on it and half are not. This false/postive thing. My doctor explained that the calcification was pushing on teh poutside of the artery and not the inside. Whatever that means. I wonder if he was jsut trying to cover the test results and sending me for the invasive catherization. Getting this CT test created more panic and worry than anything else. Even now I try to dismiss it, but it's hard. By the way, I was put on zocor as well. My total cholesterol went from 202 to 118, LDL 122 to 48, HDL 42 to 49, Trig 125 to 98. I even lost 45 pounds. I guess that's a good thing of all this.
God's Blessings on you!

[mbimom]

Hi, thanks for sharing your experience. I have a question for you about the catherization site. How long did yours hurt after? I had mine done Mon. at around 3pm and returned to work on Thurs. I have a somewhat physically demanding job. I felt ok when I went to work yesterday but by the end of the day I was sore. By the end of today I am in even more pain. Kinda about a 4. I am slightly bruised and swollen to the side of the site but no redness or warmth and I do not have a fever. Is this normal? I hate that it is now the weekend and if I do call my doc he will tell me to go to ER. I do NOT want to go back there. How quickly did you heal?

[EchoTech]

Does the bruised and swollen area have a pulse when you put your fingers on it?

[mbimom]

No thereis not a pulse that I can feel. It feels better this morning. It seems to bother me after a long day on my feet. I have to work today so I will see how it feels tonight. I just think it should be feeling a little better each day instead of a little worse. Thanks for you imput.

[EchoTech]

you are welcome.

[bertnamond]

A related discussion, heart was started.

[Onnie61]

A related discussion, Slightly abnormal picture after stress test was started.