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64 slice ct scan Angiogram vs Gold standard Angiogram

Hi i finally got a second opinion for my ongoing shortness of breath.. My cardiologist dismissed my ongoing shortnes of breath and trouble breathing after meals as it being related to a heart condition. But only i know how i feel and how bad iv felt the last two years so i chose to get a second opinion..i saw a differnt board certiffied cardiologist with over 30 years in practice and i felt he was actually lissening to me and documented everything well. the conclution was gold standard angiogram or the new 64 slice ct scan. im thinking of going for the 64 slice ct scan but in the past i remember my old cardiologist didnt like to order this test and said its not gold standard. ill be paying for this out of pocket and its more affordable than conventional angiogram. the doctor ordering this 64 slice told me if this test showed any blockage i would then have something to show my cardiologist and then i would need to have conventional angiogram for further investigating. can someone please help explain the differencebetween the 64 slice ct scan over a conventional angiogram and are there any advantiges over one or the other? im schedule for this test in two weeks and im not sure if im making the right choice, actually 64 ct scan is the only choice i have and i feel i should take it.Also does the 64 slice ct angiogram show EF calculation and does it show any possible Valve regurgition or valve abnormalitties and or possible LVH ?
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976897 tn?1379167602
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.

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Avatar universal
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??
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976897 tn?1379167602
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.
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