Cardiac imaging tests help prevent heart disease
Posted on 11 September 2018
A range of cardiac imaging tests has made it possible to look at – and inside – your heart without an overnight stay in hospital. Diagnostic radiologist Professor Leonie Scholtz, who practices at Mediclinic Kloof, takes us through advances in imaging procedures.
What is cardiac imaging?
It’s a form of diagnostic radiology that helps doctors diagnose and treat various heart conditions. There are various types of imaging, and a patient might need a combination of these for proper diagnosis and management.
How can it help me?
Cardiovascular disease (CVD) is on the rise in sub-Saharan Africa, according to a 2016 statement by the SA Journal of Radiology – and this is due to an increase in prevalence in hypertension, diabetes, obesity and other conditions.
Innovations in sophisticated cardiac imaging procedures are helping to diagnose and manage cases of CVD. Professor Leonie Scholtz, a diagnostic radiologist based at Mediclinic Kloof, says the field of diagnostic imaging has advanced more rapidly than any of the other disciplines in clinical medicine.
This technology has come a long way. “Rapid technological advances over the past 50 years have enabled faster image acquisition, better resolution and improved diagnostic applications and accuracy,” says Scholtz.
Different imaging techniques are now used for either diagnosing or treating heart disease, and the right test can result in an earlier diagnosis – which will help your doctor construct a more appropriate treatment plan. These tests paint a better picture of your heart so that your doctor is in the best position to help you.
As Scholtz says, routine and appropriate screenings can have a beneficial overall reduction in new cases of CVD in South Africa.
What are the different types of cardiac imaging?
Cardiac MRI scan
Cardiac magnetic resonance (CMR) imaging, also known as cardiac MRI, is the latest technique used for viewing your heart and major blood vessels, says Scholtz. It enables a non-invasive assessment of the function and structure of your entire cardiovascular system, providing excellent soft tissue contrast, good 3D capabilities, and the ability to view the image from any angle.
This scan will show the structure of a heart as well as the blood supply to it. As this machine uses large magnets, patients with pacemakers or any metal implants would need to make this known before undergoing the scan. Some people also find the tube of the scanner very claustrophobic, so if you do struggle in confined spaces, let your doctor know.
Positron emission tomography (PET) combined with computer tomography (CT) is a relatively new form of imaging that allows us to look at the shape and volume of the heart, as well as its biological functions, such as blood flow. “With a PET/CT scan, we can see both physiology (metabolism) and anatomy in one go,” says Dr Marguerite Morkel, a nuclear physician at the Cape PET/CT Centre, based at Mediclinic Panorama. “This helps us to diagnose diseases earlier, even if the organ might still look anatomically normal.”
Before conducting the scan, patients are injected with a radioactive tracer, so it’s not suitable for all patients. This is used to detect plaque and inflammation in the heart’s arteries.
This is an ultrasound of the heart. It shows the functioning of the heart muscle and its valves. It can detect damage from a heart attack, an infection in the heart, thickened heart walls, and congenital heart disease, among other issues. As it’s a radiation-free test, it can be repeated as necessary.
CT coronary angiogram
This scan uses iodine-based dye injected into your bloodstream through a vein in your arm so that your vessels are highlighted on the images. This test is often used to conclusively rule out coronary heart disease, or when doctors are unsure of the cause of a patient’s symptoms.
Before your scan
Your cardiologist is in the best position to advise you on which scan is the most appropriate for your history and symptoms. They should also advise you on other ways of preventing CVD, including genetic and lifestyle factors. Speak to your doctor about your risk profile, and how you can reduce your chances of developing heart disease as you age.