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Everything you need to know about Computed Tomography (CT) & CT Scanning


Special Studies

question1. What is virtual colonoscopy and what is the patient prep for the study?
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question3. What contrast do you put in the bladder (type and volume)?
question4. Are there any other drugs or medications used in CT?
questionFor applications like cardiac CT where a low heart rate is needed (60 bpm is ideal) we will often use a short acting beta blocker like metoprolol. Some of the facts for metoprolol use are listed below.

Drugs Used for Cardiac CT

  • Metoprolol is used to move the heart rate down to the 60 or less bpm
  • Nitroglycerine is used to dilate the coronary vessels at the time of the CT scan

"Oral metoprolol given 1 hour before cardiac CT effectively and safely lowers the HR in most patients."

Evaluation of the Effectiveness of Oral beta-Blockade in Patients for Coronary Computed Tomographic Angiography
Pannu HK, Sullivan C, Lai S, Fishman EK
J Comput Assist Tomogr 2008;32:247-251


"For the patients who were given oral metoprolol, more than 90% of whom received 50 mg, there was a decrease in the mean HR by approximately 10 bpm in the first half hour and a decrease in HR by approximately 16 bpm in the first hour after the medication."

Evaluation of the Effectiveness of Oral beta-Blockade in Patients for Coronary Computed Tomographic Angiography
Pannu HK, Sullivan C, Lai S, Fishman EK
J Comput Assist Tomogr 2008;32:247-251

"According to the prescibing information for metoprolol, the peak effect of an oral dose on the exercise HR occurs 1 hour after administration with a duration that is dose related."

Evaluation of the Effectiveness of Oral beta-Blockade in Patients for Coronary Computed Tomographic Angiography
Pannu HK, Sullivan C, Lai S, Fishman EK
J Comput Assist Tomogr 2008;32:247-251
"Sublingual nitroglycerin spray significantly dilates the coronary arteries and allows more septal branches to be visualized at coronary CT angiography without diminishing image quality or increasing the number of side effects."

Effects of Sublingual Nirtoglycerin on Coronary Lumen Diameter and Number of Visualized Septal Branches on 64-MDCT Angiography
Decramer I et al.
AJR 2008; 190:219-225

Nitroglycerin: Potential Side Effects

  • Tachycardia
  • Flushing
  • Headache

Nitroglycerin: Key Contraindication

Patients on ED medication like Viagra, Cialis, or Levitra should not be given nitrates. Severe side effects including low blood pressure and death have been reported in patients given nitroglycerin within 24 hours after use of these medications

CCTA:Normal RCA
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Soft Plaque LAD
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© 1999-2019 Elliot K. Fishman, MD, FACR. All rights reserved.