Our services at a glance:
Conventional X-ray diagnostics
Cardiac CT scanning
Ludwigshafen Hospital has a 128-slice cardiac CT scanner, the latest generation in a line of CT scanners. The 128-slice scanner offers a highly accurate means of producing images of the heart and coronary arteries.
Why and when is cardiac CT scanning used?
Coronary heart disease is one of the most common diseases in the western world. Coronary heart disease is characterised by narrowing of the arteries, caused when the arteries become furred up with fatty deposits, a process known as atherosclerosis. This narrowing of the arteries (stenosis) leads to an impaired blood supply to the heart. Coronary heart disease may lead to an artery, or arteries, being blocked. This is what is known as a heart attack.
Cardiac computed tomography (cardiac CT) is a technology that allows coronary heart disease to be detected early or, alternatively, it is possible to exclude significant coronorary heart disease with almost 100% certainty.
Cardiac CT is a particularly useful option for patients presenting with the following symptoms or conditions:
- Uncharacteristic chest pain in patients with low to medium risk of coronary heart disease (e.g. slightly overweight, aged 45 - 65, former smoker etc.)
- Uncharacteristic chest pain with inconclusive or borderline exercise stress test results
- Congenital abnormalities of the coronary arteries (coronary anomalies)
- In asymptomatic patients this technology can be used to measure the presence of calcium in the coronary arteries (Coronary Artery Calcium Score) in order to determine the risk of developing coronary heart disease.
Cardiac CT is not an option when patients present with the following symptoms or conditions:
- Chest pain indicative of cardiac symptoms and high risk of coronary heart disease
- Irregular heart beat (arrhythmias such as atrial fibrillation, ectopic heartbeats etc.)
- Very fast but regular heart rate (sinus tachycardia) while at rest
- Inability to hold breath for approximately 10 seconds
- Allergy to iodine containing contrast media
- Clear evidence of reduced renal function (known as renal insufficiency, stages III and IV)
How does cardiac CT scanning work and how long will a scan take?
Cardiac CT scanning is basically a type of computed tomography (CT), i.e. an x-ray scan that is taken as the x-ray machine moves around the patient's body in a circle. The important difference, however, lies in the superior imaging capacity of the CT scanner, which can produce images of multiple thin cross-sectional layers each time it circles the body.
The CT scanner used at Ludwigshafen Hospital is one of the latest generation of CT scanners manufactured by Siemens and can produce 128 cross-sectional images per rotation. This means that an image of the entire heart can be produced after only four or five rotations. What this means for you is that we are able to produce high-resolution images of your coronary arteries whilst keeping your radiation exposure to an absolute minimum.
Although the actual scan itself only takes a few seconds, we would ask that you schedule about 1.5 hours for a scan. Preparation for the scan, analysis of the results and, finally, discussing the results with you will all mean that the total procedure takes longer than the scan itself.
What happens during a scan?
Prior to having the scan you will have your heart rate measured. Should your heart rate be higher than 65 beats per minute we will administer a short-acting beta blocker to achieve a target heart rate of about 60 beats per minute. To do this, we will need to insert a catheter. This catheter will also be used later to inject a contrast medium.
In order to make a clear image of the coronary arteries possible, we will need to inject you with about 70ml of a contrast medium (Imeron).
This contrast medium is usually very well tolerated. Many patients report feeling a warm sensation when the medium is injected but this is completely harmless. Rarely, the contrast medium may cause an allergic reaction and, very rarely, use of the contrast medium may impair renal functioning or cause hyperthyroidism. If a patient is known to be allergic to contrast media, has impaired renal function or hyperthyroidism, the scan will require certain preparatory steps to be completed or it may not be possible at all.
After lying down on the scanner's sliding table you will be connected up to an ECG machine, enabling the CT scanner to adapt to your heart rate.
The scan will only take a few seconds and you will be asked to hold your breath during this time. This is necessary because the heart sits right on top of the diaphragm and is moved up and down quite significantly when we breathe in and out.
How to prepare for a scan?
We will need to see your current blood test results for "creatinine" (kidney function) and "TSH" (thyroid function) as well as a recent ECG trace.
We would ask that you refrain from ingesting anything that may increase your heart rate, such as coffee, tea or caffeinated fizzy drinks, prior to having your scan. With nicotine having a similar effect, we would ask all smokers to refrain from smoking prior to having their scan. There is nothing else that you need to do.
If you are taking medicines, please continue to take these as normal.
What happens after a scan?
A doctor will discuss the scan with you approximately 15 minutes after the scan.
If you were given beta blockers you will be asked to remain in the unit for another 30 minutes.
Your doctor will receive the results of the scan within a few days. The final diagnosis will be made in Ludwigshafen Hospital. The involvement of both the radiology and cardiology teams ensures that you will benefit from the combined expertise of both units.
What are the costs involved in having a cardiac CT scan?
Please note that cardiac CT scans do not form part of the range of services covered by statutory health care providers.
Total costs will be calculated based on currently applicable standard fees for doctors (as per the statutory document "Gebührenordnung für Ärzte" or "GOÄ"). A Coronary Artery Calcium Score costs approximately 100 Euro. A complete cardiac CT scan costs approximately 550 Euro.
Ltd. OA Dr. Bernd Cornelius
oder über das Sekretariat von Prof. Dr. Günter Layer
oder über das Sekretariat von Prof. Dr. Ralf Zahn