I believe it is down to the cardiologist and what they are used to using. I have been to both types of cardiologists. With regards to valves, this is not the standard for evaluating leaks. The standard for evaluating regurgitation is the echocardiogram and it's cost effective. The 64 slice is used as a complement to the echo, as it shows the anatomy of the valve in great detail, showing why the leak is existing. With regards to the shape of the heart, the 64 slice will definitely show this, it produces a complete 3D image of your heart. With the EF I'm not sure. I don't think so because the image is static. To evaluate EF you need to see blood leaving the heart. So, again an echo can do this, or an angiogram. 64 slice + echo are the safest procedures. Angiogram is invasive so carries risks, such as bleeding, maybe the need for a transfusion. If the catheter wire penetrates a vessel wall, you could be sent for immediate surgery. A piece of plaque could be dislodged, causing stroke or heart attack or death. The risk is still low, but you have to sign a consent form for these possibilities.
What can be ruled out with a ct angiogram? Can we see what the EF is ? Also can they find any abnormalities in the shap of the heart? And can they see any major valve regurgitatiOn? I'm concerned ? Because some people rather have a conventional angiogram and don't see a ct angiogram useful and I would like to know why??
Yes to everything. I think in the past, with the lesser resolution variations of this technology, it received a bit of a bad reputation because the images were not really sharp. The heart moves, which didn't help. However the 64 slice produces very clear images, and in 3D of all aspects of the heart.
With an Angiogram, the blockages can only be seen once they reach a substantial size. In the 64 slice, you can see inside the artery walls, giving you a warning that disease is starting. Some Cardiologists still prefer not to use this scan, but I think it's down to making change and adapting. CT Angio gives no risk of stroke, heart attack or bleeding. Go for it.