A new way to detect heart disease early isn’t for everyone

In October, Oprah Winfrey dedicated a show to women and heart disease. As part of the show, she focused on a new technology called the 64 slice CT scanner as a way to detect heart disease early. Oprah had a coronary CT angiogram (CTA) with this technology and lists on her website all the hospitals in the country that have these scanners. Barnes-Jewish Hospital is one of them.

A Tool to Answer Questions

Coronary CT angiography is designed to look for blockages in the coronary arteries. It may be used instead of cardiac catheterization or to determine if you need cardiac catheterization and intervention such as stent placement or angioplasty. Coronary CTAs can also be used to determine if you need another type of diagnostic test.

Barnes-Jewish Hospital has been offering the 64 slice CT scanner for heart use since June. The advantage of the coronary CTAs is that it''s a non-invasive, fast outpatient procedure that can provide very detailed information about coronary artery disease.

While this CT technology is exciting and useful, it''s not for everyone. And you can''t just call and ask for a scan as if you''re making an appointment for a car tune-up.

"Unlike calcium scoring or mammography, this is not a screening test for heart disease to be used on people with no symptoms," says Pamela Woodard, MD, a Washington University radiologist at Barnes-Jewish Hospital. "The coronary CTA is ideally suited for patients who have atypical symptoms and limited risk factors, such as those who are young with chest pain. It''s an alternative to a cardiac catheterization for people with atypical symptoms where we want to find out if their chest pain is cardiac-related or something else."

Coronary CTA is also ideal for patients who have no symptoms but had conflicting findings on other heart tests.

When Cardiac Catheterization is the Best Option

Dr. Woodard says the goal is to decrease the number of "normal" catheterizations — people who have very low risk of heart disease. "If the patient is normal, why put them through a catheterization?" she says. "However, if a patient is older with heart disease symptoms and strong risk factors, we would do a catheterization anyway, so the coronary CTA is unnecessary. For example, if someone came in with acute chest pain and changes on an EKG, we would go immediately to the cath lab."

Ask Your Doctor

A physician''s referral is needed for a coronary CTA. "Your doctor is the best person to determine if a coronary CTA is the right test you need to diagnose the cause of your symptoms," Dr. Woodard advises. "The information is complex so a doctor needs to look at the results to decide the next step in your treatment."

Although coronary CT angiography is a relatively new test, it is covered by many insurance policies. Calling in advance to get precertification is recommended.

To find a cardiologist or internist, call 314-TOP-DOCS (867-3627) or 1-866-867-3627.