Monthly Archives: December 2018

Cardiac CT Angiography

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Shaping the face of medicine worldwide

For centuries, the healthcare system on our beautiful island home has been behind in developments that could possibly save lives. One such development that has been behind is that of non-invasive cardiac imaging. Radiology West however is pleased to remind western Jamaican doctors that they now have, at their disposal, state of the art cardiac imaging procedures that will help in their patient management,namely, calcium scoring and cardiac CT angiography. We therefore implore you to make use of these technologies as they have been helping the world to prove and help with the following:

  1. Diabetes mellitus is associated with more diffused and severe coronary artery disease than any other cardiovascualr risk factor.
    • In a study of 229 patients, composing of both diabetics and non- diabetics, diabetics were found to have coronary calcium in an average of 2.68 vessels, more significant stenosis and a higher odds ratio to have 2 or more vessels with over 50% occlusion. A diabetic patient who has a CAC score is at a higher risk for major cardiac events. Can you help prevent such events in the next diabetic patient you see?
  2. Patient sex modifies the association between Acute Coronary Syndrome and stenosis severity.
    • On baseline, cardiac CT angiograms, female Acute Coronary Syndrome (ACS) have comparable maximal % diameter stenosis severity compared to men. The association between the degree of distal stenosis and ACS is also significantly greater in women. How then will you treat the next female ACS patient that comes through your doors?
  3. Calcium Scoring is of great prognostic value in the Asian population, especially Indians.
    • In a large multi-ethnic Asian cohort study composing of Chinese, Indians and those of Malay descent, it was found that higher coronary calcification, being of Indian ethnicity, smoker, and having higher systolic blood pressure appeared to confer a higher chance of heart attack. Do you see Indian patients with similar risk factors in your practice? Could they benefit from a calcium score?
  4. Cardiac CT angiography is useful in the assessment of patients post heart transplant.
    • If not for cardiac CT angiography, researchers at Duke University would not have been able to accurately assess the lumen volume, wall volume including any plaque, volume of non-calcified, fibrocalcified and calcified plaque as well as the degree of lumina! narrowing for various heart transplant patients in a non invasive manner. Could your cardiology consults benefit in like manner?

All studies from which these facts were garnered can be found in: The Journal of Cardiovascular Computed Tomography. Volume 12, Issue 3S. May/June 2018. Abstracts of the 13th Annual Scientific Meeting of the Society of Cardiovascular Computed Tomography


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