Patient Selection, Prep, and Management (11%)

Question 1

Technical Assumptions for Appropriateness for CCTA

Answer 1

1. 64 or more slice CT
2. Spatial resolution <1mm
3. Gantry Rotation <= 420ms

Question 2

If CCTA is for being done for Cardiac Structure, morphology, or function, all level of appropriateness is ?

Answer 2

Appropriate

Question 3

CTA in symptomatic patients with acute chest pain is inappropriate for these indications

Answer 3

1. High Pretest Probability of CAD (except for graft patency in CABG patients)
2. Abnormal ECG
3. Positive Cardiac Biomarkers
4. Poor Scan Conditions (ex. HR>70, CACS >400)

Question 4

In general, CTA for asymptomatic patients is Inappropriate. This is the notable exception.

Answer 4

Left Main Stent with diameter >3.0mm

Question 5

2 medication types to reduce heart rate in CTA.

Answer 5

1. Beta blocker (typically metoprolol)

2. Ivabradine

Question 6

In looking for reason for step artifact, what is the key area to look in determining if artifact is from cardiac motion or from breathing motion?

Answer 6

Look at ribs to see if step artifact is present there also- this would be from breathing artifact.