What does a CT angiogram show?

A coronary CT angiogram (also called CCTA, CTCA, or cardiac CT angiogram) is a 30-minute, non-invasive CT heart scan that shows your heart arteries in detail. It captures both soft plaque and calcified plaque, which are crucial for assessing your heart health. However, it costs more than a calcium score, involves iodine contrast, and has an elevated radiation exposure. In this guide, we answer the commonly asked questions.

What does a CT angiogram show?

Most of the heart problems (like regular chest pain and heart attack) arise from plaque buildup in the arteries that supply blood to the heart. This happens due to slow and silent deposition of cholesterol particles in artery walls. There are a lot of factors that influence it, including cholesterol levels, blood pressure, genetics, and lifestyle.

A CT angiogram captures the total amount of plaque buildup in your arteries as well as the degree of narrowing (stenosis). These are two of the clearest signals that your heart may be at risk.

A calcium score only detects calcified (stable) plaque. A CT angiogram detects both calcified and soft plaque, which is the kind that can rupture. This is why CT angiogram can give a more complete picture than a calcium score alone.

Who is a good candidate for a CT angiogram?

This guide is for educational purposes and is not medical advice. Please consult your doctor for medical advice.

That said, a CT angiogram may be especially valuable if you fall into one of these groups:

• Family history. People who have a family history of heart disease, defined as a heart attack or a known coronary artery disease before 55 (for male family members) or 65 (for female family members). A family history elevates the risk. A CT angiogram can give you clarity into your heart health and the power to act early.
• Proactive about your heart health. Plaque buildup is prevalent in more than 1 in 3 people by their 50s. If you want a clearer picture than relying on cholesterol markers or calcium score, then CT angiogram might be useful for you.
• Elevated Lp(a). People with high Lp(a) are at a higher risk of soft plaque in their arteries. Even with a calcium score of zero, soft plaque may be present.
• South Asian genetics. People of South Asian ancestry typically develop heart disease 10 years earlier and at a more rapid rate. They also have more soft plaque than the average population, with as much as 29% of symptomatic patients with zero calcium score having soft plaque.
• Men under 40 or women under 55. In younger people, plaque is more likely to be soft (not yet calcified), which means a calcium score could miss it entirely.

Who is not a good candidate for a CT angiogram?

• People with kidney disease (eGFR below 30). The iodine contrast dye is processed by the kidneys. In people with significantly reduced kidney function, contrast can be harmful.
• Allergy to iodine contrast. If you've had a known allergy to contrast dye, the test may not be appropriate for you.
• Pregnancy. The radiation exposure makes this test unsuitable for women in their pregnancy.

If you're unsure, a simple blood test to measure kidney function (eGFR) is typically done before the scan. Your doctor can help determine if you're a good candidate for it.

How much does a CT angiogram cost?

For preventive exams, a CT angiogram can cost as much as $2,000-$3,000 out of pocket. Getting one often requires a doctor's referral and can involve months of wait time.

At Veevo Health, we intend to offer CT angiogram heart scans at a more accessible price. Our service includes the referral, and a follow-up consultation with a doctor, making the process smooth and convenient. If you're interested, you may reserve a spot.

Is CT angiogram covered by insurance?

Insurance typically covers CT angiograms for patients with symptoms like chest pain or shortness of breath. But by the time symptoms appear, a patient usually has advanced blockages. That defeats the purpose of prevention.

A preventive CT angiogram (no symptoms, just screening) is generally not covered. You can, however, use HSA or FSA funds, which effectively reduces the cost by 25-30%.

Is a CT angiogram invasive?

No. A CT angiogram is completely non-invasive. You lie on a table, get an IV for contrast dye, and the scanner takes images from outside your body.

It's sometimes confused with an X-ray angiogram, which is an invasive procedure where a catheter is threaded through a blood vessel in your wrist or groin to your heart. That's a different test. A CT angiogram gives similar diagnostic information for most people without the risks of a catheter.

How much radiation does a CT angiogram have?

Radiation exposure depends on the scanner, your body size, and the imaging protocol. Here's how a CT angiogram compares to other common exposures:

The biggest factor is the scanner. Newer-generation CT scanners produce high-quality images at significantly lower doses. When choosing an imaging center, ask what type of scanner they use and what the typical dose is for their coronary CT protocol.

For context, a modern CT angiogram delivers roughly 1–2 years' worth of background radiation. It's not a lot but something definitely worth taking into consideration.

How to prepare for a CT angiogram

Here is the general recommendation to prepare for a CT angiogram. Your doctor or imaging center will walk you through the process beforehand.

Some imaging centers require taking a medication called metoprolol (a beta-blocker) two hours before to lower your heart rate. Others administer it on-site through an IV. A lower heart rate produces clearer images. Check with your imaging center in advance so you know what to expect and avoid the hassle of rescheduling.

What happens during a CT angiogram?

An IV line is placed in your arm for the contrast dye. Small electrode patches go on your chest to monitor your heart rate. You lie on a table that slides into an open, donut-shaped CT scanner.

When the contrast dye is injected, you may feel a brief warm sensation throughout your body. This is completely normal and passes in seconds. You'll be asked to hold your breath for 5–10 seconds while the scanner captures images.

The scan itself takes about 10–15 seconds. Total appointment time is around 30 minutes. There are no incisions, no catheter, and no sedation. You're awake and comfortable the entire time.

What to expect after a CT angiogram

You can drive home and return to normal activities right away. There's no recovery period.

It's recommended to drink plenty of water after the scan to help your kidneys flush the contrast dye. Most of it leaves your body within 24 hours. If you were given a beta-blocker beforehand, your heart rate may stay lower than usual for a few hours.

Results are typically reviewed by a radiologist and sent to your referring provider within a few days. If you get the scan through Veevo Health, a doctor reviews your results and provides personalized guidance on where you stand and what to do next.

The final takeaways

A coronary CT angiogram gives you one of the most complete non-invasive pictures of your heart arteries. It shows soft plaque, calcified plaque, and narrowing. If you want to understand your actual heart disease risk rather than estimate it from blood tests alone, this is the test.