Heart Disease

Screening with
Calcium Scoring
and Coronary CT
Angiography (CTA)
at Stamford Hospital
Calcium Scoring and CT Angiography
(CTA) can help determine whether heart
disease is present, even in its earliest stages
before any symptoms. With the information
screenings your doctor can help you reduce
the risk of a heart attack.
Heart Disease Screening
Heart disease is the number one killer of men and women in the United
States. An estimated 2 million Americans will have a heart attack each
year. Many people have no symptoms and don’t realize their health is
in jeopardy. Fortunately, new tests have been developed which can help
identify those of us at risk. Lifestyle changes, medication and, in some
cases, surgical intervention, can reduce the risk of heart disease and
enable most people to lead long, healthy lives.

Coronary artery disease (CAD) is the most common form of serious

heart disease. CAD is the end result of a progressive narrowing of the
arteries due to the presence of plaque (atherosclerosis). Plaque is made
of cholesterol, fibrous tissue and calcium. Plaque can clog arteries and
prevent oxygen-rich blood from reaching the heart. It can appear years
before the development of symptoms, such as chest pain or shortness of
breath, and can cause a heart attack without warning. Stamford Hospital
now offers two state-of-the-art medical tests that provide a convenient,
painless and non-invasive way to screen for heart disease.

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 What is Calcium Scoring?
Calcium Scoring detects the presence of calcium in the walls of
your arteries, which can help predict heart disease. Computed
Tomography (CT) is used to take a series of images of your heart
and coronary arteries. The result of this test is a calcium score and a
risk assessment that is based upon the calcium score. The score tells
you whether you fall into a low, medium or high risk of heart disease.
The presence of any calcium tells you the process of atherosclerosis
is already taking place. The amount of calcium guides your physician
regarding further evaluation and preventive treatment. The test is easy,
quick and comfortable, requiring no special preparation, dye injections
or fasting. CT Calcium Scoring does require radiation exposure.

What is Coronary CTA?

Coronary CTA can detect the presence and severity of blood vessel
narrowing by providing detailed images of blood flow in the coronary
arteries. For this type of test, contrast dye is injected into a vein to
visualize the coronary arteries and other structures, such as the heart
chambers and large vessels that carry blood in and out of the heart.
A Computed Tomography (CT) machine generates a series of three-
dimensional images that are reviewed by a specially trained radiologist
and/or cardiologist.

Coronary CTA is a safe, quick and non-invasive way to test for heart
disease. The test does require radiation exposure and injection of
contrast (or “dye”) into an arm vein. Because there is preparation
involved you will need your primary care physician or cardiologist
to schedule this appointment by calling 203-276-2602. People with
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significant kidney disease may not be good candidates for CTA.

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How do I know if heart screening is right for me?
You should consider heart screening with Calcium Scoring and
Coronary CTA if you are a man between the ages of 35 and 70,
or a woman between the ages of 40 and 70, with any of the
following risk factors:

n Family history of early heart disease

n Smoking
n Diabetes
n Elevated cholesterol
n High blood pressure
n Overweight
n Sedentary lifestyle
n Uncontrolled stress
n Postmenopausal woman
(and without estrogen replacement therapy)

Your primary care physician or cardiologist can help you determine if

you are a candidate for heart screening with CTA. Together, you and
your physician can review your medical history, family history and risk
factors for heart disease.

If you would like to get a referral to a Stamford Hospital primary

care physician or cardiologist, please call us toll-free, 24 hours a day,
at 877-233-WELL (9355). We’ll help find the right doctor for you.

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 What is special about heart screening at
Stamford Hospital?
Both Calcium Scoring and Coronary CTA are performed with our
new Aquilion 64 CFX Computed Tomography (CT) machine, the
most sophisticated CT scanner currently available. The CT
scanner rotates X-ray beams around the body, capturing ultra-thin
images of the heart and coronary arteries. These images are
reconstructed by a computer, which produces exquisitely detailed,
three-dimensional pictures.

You can have the Calcium Scoring test and the Coronary CTA at
the same time at Stamford Hospital. If you are having both tests you
must arrive 1 hour prior to the exam, which takes about 30 minutes.
Stamford Hospital’s board certified radiology and cardiology staff will
interpret the study and the results discussed with your physician.

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How do I prepare for the tests?
The Calcium Scoring test does not usually require preparation before-
hand and there are no specific instructions regarding exercise, food
intake or medications. Patients with a rapid resting heart rate (above 80)
may require medication to lower their heart rate for the test.

If you are having the Coronary CTA, your physician will give you
instructions including any necessary blood work required prior to the
exam, prescriptions and test preparation requirements. You can have
your blood work done at our Patient Testing Center at the Tully Health
Center, 203-276-7878. Your physician may prescribe a beta-blocker
to ensure that your heart rate is below 65 during the procedure. This
medication will be taken at home. If you have an allergy or sensitivity
to contrast dye or shellfish you may be given an additional medication.

Before you have the Coronary CTA it is important to closely follow

these preparatory instructions:

n Do not exercise the day before the test.

n Do not have anything by mouth at least four hours prior to the test.

n Do not consume anything containing caffeine (including decaf

coffee, tea or soda) 12 hours before the test.

n Take your usual daily medications, unless otherwise advised

by your doctor. However, you should not take any erectile
dysfunction medications such as Viagra, Levitra or Cialis for
48 hours before the test.

n Your doctor may prescribe a beta-blocker to lower your heart rate

and other medications if you are sensitivity to the contrast agent.
Please follow the exact instructions for taking these medications.

n Women should avoid wearing a bra with an under wire (hooks for
closing in the front or back are not a problem).

n Jewelry (including personal piercings) should be removed at home.

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 What happens during the tests?
Upon arrival, you will be asked to change into a gown. If you are
only having the Calcium Scoring test, you will be asked to lie flat on
a comfortable table with a wedge beneath your knees. While holding
your breath, the CT scanning machine will take a series of images of
your heart. This will take approximately 20 seconds. The test is pain-
less and, in most cases, the entire procedure should be completed in
about 15 minutes.

If you are also having a Coronary CTA, you will have an IV

(a small catheter) inserted into your arm. A Registered Nurse will
monitor your blood pressure and heart rate throughout the test. Four
sets of images will be taken and you will be asked to hold your breath
for 10 to 20 seconds for each set. The final set of images will be
obtained with the contrast agent. This may cause you to feel a warm
flush all over your body, but the feeling will pass quickly. The entire
procedure should be completed within 30 minutes. The physician in
charge may choose to give you medicine during the test to lower your
heart rate (beta blocker) or dilate blood vessels, to produce better
quality images.

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What happens after the tests?
Please drink plenty of clear fluids after the Coronary CTA test. This
will help flush the contrast agent from your body. You are free to go
home and continue your usual activities, with no restrictions.

How will I get my results?

Once the tests are complete, a board-certified radiologist and/or
cardiologist will evaluate your results and forward a report to your
physician. Your physician can use the results from these tests to
evaluate whether your risk of heart disease is high enough to warrant
taking more aggressive preventive action. Your physician may recom-
mend other tests based on the evaluation.

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 Scheduling Information
You must have a prescription from your primary care physician or
cardiologist in order to take the Calcium Scoring test. You can schedule
the test by calling the Central Scheduling Office at 203-276-2100. Your
physician’s office must order the Coronary CTA by contacting the Central
Scheduling Office. A scheduling nurse will make all of the arrangements
and contact you to explain the testing procedure to you by telephone.

Payment Information
Most major health plans including Medicare DO NOT cover these
tests at the present time. We will contact your insurance company to
determine if the procedure is covered. Payment is due at the time of your
tests, after you check in with the Patient Registration Service, located
on the first floor of the hospital. Many convenient payment options are
available, including most major credit cards. For more information about
payment procedures, please contact the Patient Registration Service at
203-276-7312.

For More Information

For more information visit our
website at www.stamhealth.org
or call us at 203-276-1000.
We will be happy to answer
any questions you may have.

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SH Signature-S (for small size, smaller than 0.45" height of the glyph)

Stamford Hospital
30 Shelburne Road
P.O. Box 9317
Stamford, CT 06904-9317
203.276.1000
www.stamfordhospital.org