Cardiac CT: A faster, clearer answer for chest pain

If you’ve ever experienced chest pain, you know that getting quick and accurate answers can make all the difference. Fortunately, doctors now have better tools than ever to find the cause of your pain. One of the most helpful is a cardiac CT scan.

Cardiac CT angiography is a noninvasive imaging test that allows doctors to clearly see the heart’s arteries. It’s now recommended as the first test for many people who come into the hospital with chest pain, especially among those who are at low or moderate risk for heart disease.

Why doctors are turning to cardiac CT angiography

For years, stress tests were commonly used to check for heart artery problems. But newer studies show that cardiac CT often provides clearer answers, helps avoid unnecessary procedures and better supports long-term care. Because of this, cardiac CT has been widely used in Europe — and U.S. heart guidelines now also recommend it for many patients.

“Cardiac CT angiography helps us see what’s really happening in the heart,” says Dr. Justin Parizo, a cardiologist with Sharp Community Medical Group and affiliated with Sharp Memorial Hospital. “For most patients, it gives us clear answers without an invasive procedure.”

Only patients at very high risk or those having a heart attack are sent directly to the cardiac catheterization lab for cardiac catheterization, where a long, narrow tube is inserted through an artery in the wrist or groin to examine the coronary arteries. For most people with chest pain, a cardiac CT angiogram offers a safer, noninvasive way to provide doctors with the information they need to move forward.

What is a calcium score — and why it matters

Another widely used type of CT scan is a coronary calcium score, which helps assess a patient’s cardiac risk. This quick heart test looks for calcium buildup in the heart’s arteries, which indicates that plaque is present.

A score of zero is especially reassuring. When a patient has a normal stress test and no detectable calcium in the heart’s arteries, it generally means there’s no need for additional testing. This approach helps many patients avoid unnecessary procedures while still giving doctors confidence in how to move forward.

Because calcium scores are so helpful, new cholesterol guidelines recommend using them to guide treatment decisions. As calcium scores rise, doctors may suggest more aggressive steps, such as lowering cholesterol goals or starting medication, to reduce future risk for coronary artery disease.

When more testing can help

If a patient has concerning cardiac symptoms or a higher calcium score, doctors may recommend a cardiac CT angiogram, which uses contrast dye to provide a closer look at the arteries and any plaque that may be present.

Even so, doctors stress that not everyone needs every test. “If the treatment plan is already clear, and both the patient and doctor feel comfortable, more testing isn’t always necessary,” Dr. Parizo says. “The goal is to use these tools when they truly add value.”

CT angiograms are also very safe but are reserved for situations where the added information can help guide care. Calcium scoring, which doesn’t require contrast dye, carries very little risk.

A personalized approach to heart health

Cardiac CT allows doctors to tailor care to each patient, whether that means reassurance, lifestyle changes or medication. The goal is to catch problems early — before a heart attack happens — while avoiding unnecessary procedures.

“One of the biggest benefits of cardiac CT is the peace of mind it provides,” says Dr. Parizo. “For many patients, we can confidently say their cardiovascular risk is low. Or, if we see early signs of disease, we can act before it becomes something more serious.”

With advances in imaging and a personalized approach, cardiac CT is changing how doctors evaluate chest pain, helping patients gain peace of mind today while protecting their heart health for the future.

Learn more about cardiovascular care at Sharp Memorial Hospital, which has earned certification from The Joint Commission as a Comprehensive Cardiac Center; get the latest health and wellness news, trends and patient stories from Sharp Health News; and subscribe to our weekly newsletter by clicking the "Sign up" link below.