CT scan with contrast?

[Flutterby63]

I've shown up as having an irregular heartbeat after various tests including ECG and Bardy test. The cardiologist has said I should have a CT scan with contrast. He also gave the option of heart monitor test instead (can't remember what they call it but you have to run and they gauge heart rate etc.

I said I'd have the CT as he suggested it was more accurate.

But I've just looked into side effects on the NHS site and it includes a slightly higher risk of cancer through radiation.

Should I ask to have the heart monitor test instead? There is a cancer risk in my family as my Dad had a form of genetic-related cancer?

I don't know but I think that CT chest scans (certainly lung scans anyhow) increase the risk of breast and blood cancers although not massively.

Can you have the running one and then the CT after that if necessary?

One CT scan is unlikely to make much difference to your cancer risk.

Given that you are trying to manage a potentially serious health condition - that could kill you far more quickly than a minutely increased cancer risk - I would take whichever test is more accurate.

Thanks for the responses. It makes the risk 1 in 2000 and says it can be the equivalent of btw a few months and a few years extra radiation on the body, so I'd say it's significant when there is already a genetic likelihood of cancer?

I think I will go with the other test as suggested.

Thanks

BMJ understanding risk

Is it a CT cardiac angiogram he's suggesting?

Thank you, maths isn't my strong point so struggling to understand the BMJ link. Yes I think that's the test.

CT cardiac angiography is relatively low dose. If their concern is the blood supply to the muscles of your heart, it's a good enough test. The one I'd pick. They can't always do it if a) your heart rate is too high, and can't be slowed with beta blockers, or b) your heart rate is all over the place.

The radiation dose? Shrug your shoulders. It's, effectively, nothing. The staff will only give you the minimum necessary to attain the required results.

If your referrer thinks CT is 'the more accurate test' for you, I'd do it.

Your 'genetic risk' for cancer is, and will always be, all over the shop in terms of actual risk. No one knows what anyone's actual risk is. The factors that determine this are largely still unknown.

It's your body, your choice. Obviously. But if you were me, I'd be thinking the chances of the tests, like CT, pinpointing, thus hopefully treating my condition, making anything worse were low. And go for it.

I will happily talk you through the process of CT cardiac angiography if that helps.

Thank you so much for the detailed response here. I think it's the detail on the NHS site that worried me: "Generally, the amount of radiation you're exposed to during each scan is the equivalent to between a few months and a few years of exposure to natural radiation from the environment.

It's thought exposure to radiation during CT scans could slightly increase your chances of developing cancer many years later, although this risk is thought to be very small (less than 1 in 2,000)."

I have to say, 1 in 2000 doesn't seem that small to me, when compounded with my already higher risk of getting the cancer my Dad had. (Although I appreciate the cancer risk thing is complex).

The cardiologist only said it was more accurate when I literally pushed him for the answer, otherwise he was happy for me to choose.

I've also got an underactive thyroid and think that, having read all the helpful replies here, I should speak to the cardio again and talk it through in detail.

Thanks again.

Are you quite young? I'm asking because with older people they don't seem to worry about the cancer risk, I guess as it would only appear many years later, you would probably have died of other causes by then! But yes explain your concern to your consultant.

When my ECG showed a heart murmur I had an echocardiogram which examines the valves, function of the ventricles, thickness of the heart wall and ejection fraction of amount of blood flowing through the aorta to the body.
Recently I had a CT angiogram to examine the coronary arteries which showed a 70% blockage. I did have to take beta blockers to reduce my high pulse rate down to 60 per minute after topping up at the pre op. I have a normally high heart rate .

also had a CT scan to detect calcium deposits in/on the heart which did not need the contrast dye at the same appt time.

They did want to do a Under Stress echo but it was not safe with my leaking heart valve so it was changed to the CT scan.
They will ask if you are allergic to the radioactive iodine dye.

I assume you have had an ultra sound on your heart?

You could ask your cardiologist if a cardiac MRI is a possible alternative to the CT so as to avoid the radiation exposure. But this will depend on what's available to you locally.

Thank you. I'm early 40s and slim, so the heart issue is a little surprising. I also know people who've died of cancer at my age, so I suppose it's a bigger concern. My Dad had cancer at 60 which isn't that old nowadays.

I've had an echogram already, along with ultrasounds.

They can't give me beta blockers because pressure is already low.

I think I'd prefer the alternative test I've been offered. It is private health though so MRI might be an option.

Thanks

Correcting digerd- X-ray contrast (dye) is iodine, but isn't radioactive.

I don't know much at all about cardiac MRI but I will ask.

Deep in my professional soul, I suspect that if it were the golden test for cardiac issues, it would be far more widely financed by the state.

My 15 year old daughter had to a have a cardiac CT with contrast last year, we were told it was equivalent radiation to a long haul flight by the anaesthetist.
We had no option as they needed a CT as ECHO imaging for her heart defeat is limited so I am not going to worry about it.

Thank you for your replies. I'm waiting for the cardiologist to come back on this so he can assess based on my specific case.

The alternative offered to me was the Under Stress test and for my own peace of mind, I'm going to see if that's still an option.

I hope that those of you have had needed these tests or know people who did are doing OK health-wise.