Coronary CTA: ANY OF IT ACCURATE.

[hefner33]

I have attached the report to this post.

I had a recommended Coronary CTA to initially check the structure of my coronaries. I had a maternal grandparent pass of scale with  undiagnosed defected coronaries. Over the lastop year I have also had chest pressure on exercise exertion and a syncopal episode after running. I have frequent pacs/pvcs/pjcs and stay bradycardiac most of the day. So reason for the test and I wanted non invasive.

Anyway the test quality apparently wasn't good stating significant slice misregistration. The reader read it before the slides were done and everything was normal. Then came back when the slides were all available and said I had hypokenesis with a ejection fraction of 15%. My cardiologist didn't think that was right and asked the reader which said he may have read it wrong. So I had an echo 3 days later and my ef was 60+.

I questioned my cardiovascular on the validity of the coronary findings and he seemed a little agitated I'd ask because he stated the MD that read it wouldn't put down findings he wasn't sure about.

So does significant slice misregistration hinder the reading of the coronary arteries?

It's hard getting a second opinion especially outside the  group that did the test and all my physicians are all on the same affiliated hospital.

I still have these symptoms but I've been told that they are 99.9% sure it's not heart related but have no answer to what's causing my problems

[hefner33]

Hey.
No Im not. I was questioning getting a second read for the whole test. Like you said the wrong reading of 15% EF, maked me question how valid all the other readings were. Like Ed said above, it seemed the interpreting dr was asleep or something. And when i asked my normal cardiologist about this, it seemed there was a bit of offense taken cause this was a colleague to him.

So I asked here for anybodys experience with CTA readings with apparently bad quality and how much I can trust it. With the fact he read i had a 15% ef and reported it and the following echo showed 60+, how do I know his reads of the other structures are accurate.

With that said, its difficult to get in another group just to have my test read again

[is_something_wrong]

I hope you don't ask for further testing involving radiation. Your coronary arteries are fine and according to your echo, EF is normal. Your doctor must without a doubt have read the results wrong. An EF of 15% would likely have caused severe symptoms. And it doesn't just happen without any reason. An EF that low is usually only seen after massive heart attacks or severe ventricular dilation.

CTA is very reliable in finding coronary blockages, and you are young.

[hefner33]

Yeah. Thats what I would like to do but not sure how to get a cardiologists outside this group that can actually read a cta. My main cardiologists wasnt the one that read this one, just ordered and reported it to me. So if i went to another group id have to figure out who can read a CTA

[ed34]

Yes it's very neat :)  I would have another Doctor look at your results to confirm everything is ok. It sounds like the team were half asleep on the day.

[hefner33]

Heres something pretty neat if yall want to see it. 3D of my CTA

http://screencast.com/t/sHpomwsEd3WV

[hefner33]

Hey Ed

It was  CTA. And yes I had the iodine through IV. Actually picked up the imaging cds today of the test and the 3d pictures of your heart is quite fascinating. Might see if I can upload some pictures to my profile later on

[ed34]

I'm confused? Was this a CTA or a calcium score? A CT-A scan is actually very good for looking at vessels. As far as I'm aware you should have had an iodine tracer injected into your arm to highlight the vessels? You know, when my bypass shut down they couldn't find one of the veins during a normal angiogram but the CTA discovered it. I had the dye injected through my arm as the procedure took place and felt hot from this. Is this not what you had?

[hefner33]

Gotcha. Thanks

[Occupant]

I am aware of what "they" are saying, but all you have to do is search through this forum. You'll find several posts where people were complaining about having had a heart attacks and: "I had a CT-A and they didn't find anything. How come?" And you shouldn't compare the Cleveland Clinic with everybody that does these tests.

[hefner33]

Thanks. To my understanding I was told this was different than just a calcium scan. That it would identify plaques (soft and hard) as well as calcium. Thats what the Dr told me and I hope so cause this test was alot more expensive.

Just googled and this came off Cleveland CLinic
" this new technology has consistently shown the ability to rule out significant narrowing of the major coronary arteries and can noninvasively detect “soft plaque,” or fatty matter, in their walls that has not yet hardened, but that may lead to future problems without lifestyle changes or medical treatment. "

Ive had stress test in the past, About June of 2014 which they go by and I scored pretty high on it then but wasn't having chest discomfort but was highly active right before then. Think my score was 15.0. Thanks again for your input!

[hefner33]

Thanks for the replies. And sorry for the typos I just realized. Auto correct.

I didn't either and the problem with the quality is that its not a test I would like to redo since the exposure to radiation is quite high with this type of test. All my records are in the group and with the affiliated hospital and I just had them all changed over to this group from moving. Its what I want to do but just wanting to make sure Im not making a fuss over something that was done correctly but just was bad quality. Thanks for your input

[Occupant]

There were, obviously,  no Calcium Phosphate deposits in your arteries otherwise the scan would have, no matter how bad, definitely seen them. However, soft plaque as a different matter - even successful CT-A's might miss it. Your EF based on the subsequent Echo is OK. What's next? I would do a Thalium stress test and go from there.

[Al Dente]

Personally I would have no confidence in the study.  The report summarizes in itself it is of poor quality.  If you had a 15% EF would have little if any energy and have significant issues.

The comments by the radiologists and others delineating responsibility shows that there is a problem with the test itself and the interoperation.  If I were you I'd find a 3rd party not related to these groups and have the test repeated.  I would as well discuss your issues with another cardiologist.  The heart has to be ruled in or out.  If someone told be that there was a 99.9% chance it's not cardiac--I would not have much faith in the statement.  Given your symptoms I'd find a new cardiologist.