CT Coronary Angiography

Non-invasive contrast-enhanced CT examination of the coronary arteries that produces three-dimensional maps showing the location, extent, and composition of any stenoses or plaques — without catheter insertion, without hospitalisation, and with a radiation dose a fraction of conventional angiography.

CT coronary angiography at Medimage SA uses a latest-generation CT scanner to produce high-resolution three-dimensional images of the entire coronary arterial tree following a brief intravenous injection of iodine-based contrast dye. Unlike conventional coronary angiography — which requires threading a catheter from the groin or wrist into the coronary arteries under fluoroscopic guidance — CT coronary angiography is entirely non-invasive, performed on an outpatient basis, and completed in under 30 minutes from arrival to departure. The examination begins with cardiac gating: ECG electrodes are placed to synchronise the CT acquisition to the resting phase of the cardiac cycle, effectively freezing the motion of the beating heart and enabling millimetre-resolution imaging of structures only a few millimetres in diameter. Contrast dye is administered intravenously, and the scanner captures the coronary circulation as the bolus perfuses the arterial system. The resulting dataset is processed by the radiologist into multi-planar and three-dimensional reconstructions that display each coronary artery — left main, left anterior descending, left circumflex, and right coronary — along its full length from multiple perspectives. Any narrowing (stenosis) is graded by its estimated percentage reduction in lumen diameter; the location, length, and plaque composition (calcified versus non-calcified, or mixed) are documented in the findings report. Crucially, CT coronary angiography detects not only the calcified plaques that appear on a calcium score but also non-calcified (soft) plaques — lipid-rich deposits that do not calcify and are therefore invisible to the CAC scan alone. These soft plaques are widely recognised as carrying the highest risk of sudden rupture and acute myocardial infarction, making CT coronary angiography the more comprehensive risk assessment tool when anatomical information is specifically required. At Medimage SA, this examination can be performed as the second stage of a combined cardiac CT appointment that begins with a calcium score, or as a standalone investigation. Dr. Monica Deac — a cardiologist specialised in cardiac imaging — is part of the radiologist team, ensuring that cardiac-specific protocol decisions and result interpretation are supported by cardiology expertise as well as radiology training. Preparation typically includes avoiding caffeine, nicotine, and strenuous exercise for several hours beforehand. Current kidney function tests (serum creatinine) are required before contrast administration; thyroid function is also checked where clinically indicated. Patients taking metformin should follow specific guidance from the practice. No general anaesthesia or sedation is required; the examination is performed while the patient is awake and comfortable on the CT table. CT coronary angiography is fully appropriate for outpatient use without hospitalisation. Swiss complementary insurance or self-pay applies; KVG/LAMal covers the examination when referred by a physician for medically indicated coronary artery disease assessment.