Is it possible for a CT scan to rule out angina?

Angina is chest pain caused by blockages in the coronary arteries: coronary heart disease. It may also be accompanied by shortness of breath and/or nausea.

A CT (“cat”) scan uses radiation to create an image of the heart, so can this device detect angina?

“No. Angina is a symptom that must be provoked by a stressor or stress test,” says Pilar Stevens-Cohen, MD, FACC, Department of Cardiology, South Nassau Communities Hospital.

“A coronary CT is a non-provocative test. You can see soft plaque and calcified plaque and measure the degree of obstruction.

“However, you cannot tell if a patient’s symptoms are related to that obstruction.

“This is the limitation of coronary CT and why provocative testing with stress tests is the preferred method for diagnosing angina.”

A stress test is often done with a treadmill; the patient walks slowly while the angle of the tread surface is gradually increased to simulate a hill.

Another way is with a stationary bike. A third way, for people who are unable to use their legs such as those with knee problems, is with a drug that makes the heart think that it’s exercising.

As for the CT scan and angina detection — think of it this way: Can an X-ray show joint pain? No. It can show arthritis, but it can’t show the symptom of pain.

Angina is a symptom — chest pain and/or shortness of breath are the two most common — that’s caused by inadequate blood supply through the heart — due to excessive plaque buildup that narrows the inner diameter of the arteries.

Risk Factors for Clogged Arteries — no particular order

  • Smoking
  • Obesity
  • Absence of structured exercise regimen
  • Excessive daily sitting
  • Untreated sleep apnea
  • Junk food diet, or diet of mostly processed goods, even if you’re thin
  • Cocaine use
  • Advancing age
  • Family history of early-onset coronary artery disease

Dr. Stevens-Cohen is board certified in cardiology, nuclear cardiology, echocardiography and internal medicine.
Lorra Garrick has been covering medical, fitness and cybersecurity topics for many years, having written thousands of articles for print magazines and websites, including as a ghostwriter. She’s also a former ACE-certified personal trainer.  


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