Have my first CTA scan coming up....what should I expect??

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Roxx_yer_Soxx

Well-known member
Joined
Dec 8, 2009
Messages
62
Location
Lima, Ohio
Hey gang, been probably 6 months since I have been on here.
Had my annual checkup last week (which I dreaded for 2 weeks)
and the cardio informed me that he was hired at the Cleveland Clinic, and this would be our last visit (dang, that makes 2 cardios I liked that are leaving me)

Anyway.... he said.....everything looks good.....see my partner next year.

Wait...wait...wait..... all he did was listen to my chest and have me do a EKG.

Last time I saw him, he asked me if I really cared to know if I have a bicuspid or not (2 echos have showed either a BI or irregular Tri...currently working fine, no regurge or stenosis.....and if I really cared about the precise size of the Aortic Root...one Echo showed 3.4, another 3.8)

Aortic Valve Area opening was 2.5 on one Echo, 2.425 on another....so this is not a concern,and both cardio's called this excellent.

So...with my persistance I requested some sort of test be done this year, if for no other reason to get a baseline.

So my options were a TEE ( transesophageal echocardiogram ) or the CTA (Coronary computed tomography angiography)

I opted for the CTA..... while my cardios I have had in the past don't seem too concerned about anything.... I am interested to know 1) Just what kind of aortic valve I have 2) The size of my aortic root 3) And to make sure everything on the asending and arch are ok.

What can I expect with this test? How long does it take? I realize I will be injected with dye....I am not allergic to anything as far as I know.

Thanks alot.
 
I remember mine lasting about half an hour total. 10 minutes or so to prep, put a line in, discuss the procedure, get everything ready. 5 minutes or less for the scan itself. 15 minutes of reading magazines afterwards waiting for final observation and release. No big deal for most (reactions to the dye are the exception), no restrictions after. Here's also an overview I had found: http://my.clevelandclinic.org/heart/services/tests/radiograph/ct.aspx
 
I had my scan last Wednesday. They did a CTA of the chest and of the abdomen. I required two doses of dye. When I went it my heart rate was all over the map from 65 to 100. They waited to see if it would relax but it didn't' so they gave me a beta blocker and I went back in 30 minutes later. Finally my rate was stable the test began. Took 20 minutes after that. You probably wont have this problem at all, it should be in and out for you.

The only thing you got to be ready for is when they inject the dye. You most likely will feel a very warm sensation in the lower half of your body if not your whole body. It will feel like you have to go to the restroom. Really strange feeling. But it usually subsides quickly. Other than all that, its a walk in the park. Let us know how it goes.
 
The test itself wasn't a major deal for me. My biggest struggle was getting the IV in (they ended up calling the ultrasound tech to put it in) and they couldn't get my heart rate slow enough so I had a lot of beta blockers and nitro, which made me end up with a horrendous headache. I've had a TEE done as well and I'd have to say the headache from the nitro was worse than the TEE mainly because they dope you up and you don't remember it. Good luck!!
 
Well, I got through it, but the dye lit me up.... little warm was a understatement. I felt like I was in a pot of boiling water for about 10 seconds.....I was kicking my feet around....LOL! the guy is like, "are you ok?" But other than that....there was nothing to it. Thanks for all the tips.
 
Nice.... Cat lab just called and said my pictures didn't turn up very well, and the radiologist wants me to repeat the procedure.
Agggghhhh!!
I am a high strung anxiety guy as it is..... I worried for a week before the 1st one, and now I get round two 48 hours later.

Anyone know how much radiation these bad boys are putting out? In my worried mind I can see them saying "Mr. Roxx the good news everything looks good on the CTA, the bad news is you have been exposed mass quantities of radiation." :)
 
Pictures didn't turn up very well? What did they forget to turn it on or something? Wow, that's disappointing. I know it's not something you want to do excessively, but no clue how much is too much, or too soon. I've seen them compared to atomic bombs before, so that's never a good sign, but I assume that was a slightly biased or non-medical analysis. I hope. I'd certainly be curious to know too.
 
Here is my thoughts tonight.

I volunteered for this CTA because i wanted to know if I have a true Bicuspid or not....

My last 2 echo's have been inconclusive

I am not sure doing this radiation 2 days apart is such a great idea.
 
I would want to know why they think the pictures didn't turn out, before going thru another one, that is pretty much just to know if you have a bicuspid valve. I wonder if your moving and kicking your feet had to do with the bad pictures, then at least you would know you could do something different to hopefuly get better pictures.

Have you had an MRI/MRA? FWIW Justin has had 5 OHS and the ONLY time he had a CT was to check for a pulm embolism when he had a post op infection and they were trying to figure out what was going on. He has MRI routinely, since they don't have the risk of radiation
 
I am sure my movement is what screwed the picture up....as i looked like a fish out of water I am sure...when they called, it was a tech that said "dont be alarmed, the radiologist didn't find anything wrong, its just the pictures did not turn out well, and he would prefer to redo the test."..... my rational tells me that had they thought that they saw something, it would have been someone higher up the food chain on the pay scale than a tech that would have called.

My cardio said this word for word "this bicuspid thing doesn't concern me with numbers like yours, maybe it is a bicuspid,maybe its not, at this point, it doesn't really matter, why don't you see us again next year?"

I said..... "I want to find out if I have a bicuspid, and I hear that the CTA can give a more accurate size of aortic root

He said "Again, you have a great valve opening of 2.4 or 2.5, no stenosis or regurge.....your 2 echos show your root somewhere in the 3.4 to 3.8 range, which again, is nothing..... I would wait, give it a year, then we will do a checkup."

Me: Long pause with a pissy look on my face

Him: ok....if you want to do the CTA now, I can schedule it.

After thinking about it.... 1) I had to sign a release that said I understood that the radiation absorbed from this test is the equivelant of what I would have received in 2.6 years of everyday living. 2) Considering that my cardio didn't even think I should do the test....I have no symptoms.....I feel that perhaps I let my emotions get the best ofme, and really, there are folks who probably need that machine for testing more than I do.

In a nutshell, I have anxiety and negative thoughts about having a huge bulging aneurysm something, this is why I wanted the tests.... but I am thinking that if that were the case, maybe that would have showed on the 2 Echo's I have had, or the 2 chest xrays.

I am new at this guys, and I certainly haven't been through 1/100th as some of you, but I thinking at this point, perhaps a CTA is more than I really need...... opinions welcome please!
 
Duffey said:
Fast answer, it's probably more than you need.
Click to expand...

I agree w/ Duffey.
I'm sure IF you had a "huge bulging aneurysm something" even with the pictures not being the best, they most likely would have seen anything like that on the CT you just had. I personally would take your doctors advice and wait a year to have any more tests done..and even then I probably would ask about a MRI before having a CT scan and the uneeded radiation. Who knows, you're pretty young, there MAY come a time when you NEED to have numerous CT scans or other things that involve radiation. Since radiation exposure and its risks are measured over a lifetime, with maximum "safe" levels, I probably would think pretty hard before having extra tests that use relatively high doses of radiation, that really aren't needed.
Plus even tho you aren't paying for it yourself, they are pretty expensive.

Good luck with your decisions, I hope you are able to find a way to put you heart/valve to the back of your mind and not worry about it as much, and enjoy this time of your life with your wife and young children.
 
Last edited:
Excellent advice. I think I will just continue with regular follow ups, and pass on addition CT scans for now.
I am fortunate to have excellent health insurance, but that is not a reason to abuse the insurance system or my
body with un-needed radiation.

While I am curious to know what exactly my valve is, and the true dimensions of various things, the facts are at 33 years old, my numbers are at worst on the higher side of normal, and certainly not anything that would require any surgical intervention at this point, so with that said, it really makes no difference what the spefics are.....of course the rational brain in me knows this, but easier said than done.
 
Roxx_yer_Soxx said:
I think I will just continue with regular follow ups, and pass on addition CT scans for now.
Click to expand...

Sounds good. You know, I just reread one of your posts above, and realized your 3.4-3.8 numbers are actually your root. The normal size range for the root is around 1 cm larger than the typical sizes we so often see for the ascending aorta. I did not realize this myself until a few weeks ago when I was reading through the ACC 2010 Thoracic Aortic Disease Guidelines (http://content.onlinejacc.org/cgi/content/full/j.jacc.2010.02.010 and http://content.onlinejacc.org/cgi/content/full/55/14/1509/TBL3) The chart lists the normal diameter size ranges, and for a male, the normal root range is 3.63 to 3.91.

So, I think you may just be perfectly normal. Enjoy it!
 
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