Medically reviewed by Dr Nabila Laskar, Consultant Cardiologist (GMC 7040901). A CT coronary angiogram is a detailed scan that images the coronary arteries directly. It is now the recommended first-line test for most people with new, stable chest pain.
The scan reveals narrowing of the coronary arteries, the amount and type of plaque present, and the calcium score — a strong predictor of future cardiovascular events. See /conditions/coronary-artery-disease.
People with stable chest pain or exertional breathlessness where coronary disease is possible, and selected individuals with a strong family history or high calculated risk. It is not used for acute chest pain, which is a 999 emergency.
You may be given medication to slow the heart rate and a nitrate spray to widen the arteries, then an iodine contrast injection during a scan lasting a few minutes. Caffeine is usually avoided beforehand and kidney function is checked in advance.
Results guide treatment: a normal scan is strongly reassuring, non-obstructive plaque prompts intensive risk-factor and cholesterol treatment (see /conditions/high-cholesterol), and significant narrowing may lead to further testing or revascularisation. Dr Laskar explains findings and the plan in a follow-up consultation.
It is a low-risk outpatient test. It involves a small radiation dose and iodine-based contrast, so kidney function and allergy history are checked beforehand. The clinical benefit generally outweighs the small risks when the test is properly indicated.
It quantifies calcified plaque in the coronary arteries. A score of zero is highly reassuring, while higher scores indicate more atherosclerosis and usually prompt more intensive risk-factor treatment.
It should be requested by a cardiologist after clinical assessment, so that the right test is chosen and the results are interpreted in context. We arrange referral and review the results with you.
A CTCA is a non-invasive scan with no catheter and no hospital stay. An invasive angiogram uses a catheter inserted via the wrist or groin and allows stenting during the same procedure, so it is reserved for higher-risk or already-identified significant disease.