Cardiac CT Scan

Re-posting this from a comment I made on an old thread in case you are scheduled for one and want to know what to expect. I also have a couple of questions about my results:

"I had a Cardiac CT scan today (5/24)(to get more detail from a recent echocardiogram)  and I have a Medtronic dual lead PM.  There were no issues during the scan with my PM and it was a painless procedure, other than the pain of getting an IV.  A few things to be aware of.  Did not change into a gown, they did place chest electrodes and take blood for kidney function testing.  They want your heart rate to be at 60BPM max to get the best pictures, but since I have bradycardia and my PM is set to a lower limit of 60BPM I was fine.  Otherwise they have to medicate you to bring it down and that may take an hour.  The contrast medication (iodine) does give you hot flashes in the face and the genitals so be ready for that.  Halfway through the 10 minute procedure you get nitroglycerine under your tongue to dilate your arteries for a better picture as well.  I did not have any side effects from the nitro. 

Drove myself to and from with no issues and no help.  The CT scanner is much more open than an MRI tube and I did not have any issues with anxiety.  In and out in about 45 minutes. Oconee Memorial Hospital, Seneca, SC.

Waiting to hear from the cardiologists if I have anything to worry about."

Got the results: 

My two previous echocardiograms (one just prior to my PM implant, one 6 mos later) show mild mitral valve regurgitation progressing to moderate.  However, the cardiac CT scan result makes no mention of the mitral valve yet my cardiologist says it appears normal.  Also, my LV ejection fraction dropped from 65% pre pacemaker to 50% on the latest echocardiogram and now 43% on the CT scan.  Cardiologist says the CT scan may not be accurate.  How do I reconcile the test results, which are more accurate?  I do feel less energetic when exercising and tire more easily so I suspect my heart efficiency has dropped somewhat but it is difficult to quantify.  My concern of course is dyssynchrony progressing with an eventual need for cardiac resynchronization as well as the mitral valve issue.

I follow up with my electrophysiologist on Jun 7th and cardiologist Jul 31st. 

KH

3 Comments

Thank you for the update

by Gemita - 2024-06-03 11:00:22

KH, thank you so much for that excellent account of what to expect from a Cardiac CT scan. 

I don’t think we will ever be able to compare satisfactorily the results of an echocardiogram with the results of a Cardiac CT Scan because they are clearly different imaging techniques, with very different levels of operator experience and therefore results can vary greatly.  

For example with an echocardiogram, good body positioning is so important to get optimum views, since body shape and size can be extremely variable and may make visualization and assessment difficult which is why I sometimes get comments like:  sub-optimal views mentioned on my echocardiogram. 

It is not uncommon for things to show up/not to show up on an echocardiogram that have the potential to be clinically significant, or not significant, so that is why they often ask for a CT or MRI to look more closely at our hearts to make sure nothing is missed.

I know it is somewhat disappointing to feel unwell and not to get a satisfactory answer for our symptoms.  I hope your EP or cardiologist will be able to throw some light on this.  From your results so far though, I cannot personally see anything to really worry about.  I am sure they will be keeping a close watch on your ejection fraction.  When you see your EP and cardiologist, I would ask all the questions that concern you, especially about dyssynchrony and the degree of leakage of your mitral valve and whether it could be causing any symptoms.  Some of us are very sensitive to what is going on in our hearts, especially when we are in certain positions like bending over, when we are active or having rhythm disturbances. 

In the UK we wouldn’t normally be offered a CRT pacemaker unless our ejection fraction dropped below 35% or we showed clear signs of heart failure from right ventricular pacing.  Many of us though, fortunately, never go on to develop heart failure from dyssynchronised pacing and I hope it will be the same for you too.

Thank you again for your post.  I found it extremely helpful

"dyssynchrony progressing with an eventual need for cardiac resynchronization as well as the mitral valve issue"

by USMC-Pacer - 2024-06-03 13:28:19

Sometimes correcting the dyssynchrony can mitigate the mitral valve regurgition. My "mild" regurgitation went to no regurgitation once they got my CRT optimized. After already having an aortic valve replaced, I was worried that the mitral valve was next. But, for me, CRT corrected that. 

If you are not a candidate for CRT, perhaps they can tweak your dual chamber device to address dyssychrony? 

 

Here's a link:

https://ncbi.nlm.nih.gov/pmc/articles/PMC6615993/

Cardiac CT

by KHammond - 2024-06-04 18:29:48

I will definitely ask if they can adjust the "timing" of my PM to address any dyssynchrony issues.  I appreciate the link to the article but goodness, that is dense with medical jargon.

All in all, I think I am doing well all things considered, just want to recapture some of the energy I had before all this started.

 

KH 

You know you're wired when...

You have a new body part.

Member Quotes

But I think it will make me feel a lot better. My stamina to walk is already better, even right after surgery. They had me walk all around the floor before they would release me. I did so without being exhausted and winded the way I had been.