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CT Coronary Angiography (CCTA)

Non-invasive imaging of coronary arteries with contrast-enhanced CT, providing high diagnostic accuracy for excluding coronary artery disease.

Written by: Saygı Hospital Health Guide Editorial Board
Last updated:

This content has been compiled by the Saygı Hospital Health Guide Editorial Board and is periodically reviewed by a specialist physician.

References (5)

This content is for informational purposes only and does not constitute medical advice. You can book an appointment at our Radyoloji department. Book Appointment →

What is CT Coronary Angiography (CCTA)?

Coronary CT angiography (CCTA) uses high-resolution multidetector CT (≥64 slice) with retrospective or prospective ECG gating and iodinated contrast injection to produce 3D images of coronary arteries. Modern dual-source and 256/320-slice scanners enable single-heartbeat acquisition with effective doses of 1-5 mSv.

Indications include evaluation of stable chest pain in low-to-intermediate pretest probability, exclusion of CAD in symptomatic patients, anomalous coronary anatomy, post-CABG bypass graft assessment, post-PCI in-stent restenosis (limited by metal artifact), structural heart disease pre-procedural planning (TAVR, mitral interventions) and acute chest pain triple rule-out (CAD, pulmonary embolism, aortic dissection).

Image quality requires heart rate <60-65 bpm (often achieved with metoprolol 50-100 mg PO 1 hour before or IV at 5 mg increments), nitroglycerin sublingual for vasodilation, breath-hold capability and contraindication-free contrast administration. Coronary artery calcium score (Agatston method) is performed initially without contrast for risk stratification. CAD-RADS 0-5 scoring system standardizes reporting. Post-CCTA functional assessment with FFR-CT or stress imaging may be needed for moderate stenoses (50-70%).

Symptoms

Test, not a disease — clinical indications:
Stable chest pain or angina-equivalent symptoms
Low-to-intermediate pretest probability of CAD
Atypical chest pain with positive risk factors
Pre-operative cardiac risk stratification
Anomalous coronary artery suspicion
Post-bypass graft patency assessment
Acute chest pain triple rule-out protocol

Risk Factors

Patient factors limiting study quality:
Heart rate >65-70 bpm (despite beta-blockade)
Atrial fibrillation or frequent ectopy
Inability to breath-hold for 5-10 seconds
Severe coronary calcification (blooming artifact)
Body habitus (obesity affecting image quality)
Renal insufficiency (contrast risk)
Iodine contrast allergy

When to See a Doctor?

If you experience any of the following symptoms, seek medical attention promptly:

  • Stable chest pain with low-intermediate risk
  • Inconclusive stress test results
  • Pre-TAVR or mitral intervention planning
  • Anomalous coronary artery on prior imaging
  • Post-CABG graft patency evaluation
  • Acute chest pain (triple rule-out indication)
  • Strong family history of premature CAD
  • Calcium score for cardiovascular risk stratification

Treatment Methods

01
Pre-test heart rate control with beta-blockers
02
Sublingual nitroglycerin 0.4 mg before scan
03
Iodinated contrast injection (60-100 mL)
04
ECG-gated acquisition (prospective preferred)
05
Calcium scoring without contrast (risk stratification)
06
CAD-RADS reporting and functional FFR-CT if needed
07
Lifestyle modification and statin therapy if CAD found
08
Invasive coronary angiography for high-grade stenosis

Which Department to Visit?

You can visit our Radyoloji department for these complaints. Our specialist physicians will create the most suitable treatment plan for you.

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Health Disclaimer: The information on this page is prepared for general informational purposes only. It does not replace medical diagnosis and treatment. Please consult your physician for your complaints. Saygı Hospital does not accept responsibility for actions taken based on the information on this page.