Electron Beam Tomography: The Safer Alternative to Angiograms

By Larry Trivieri, JR

Picture this scenario: You doctor calls you to discuss the results of the blood tests he ran for you to screen for heart disease. She tells you that your test results indicate that you might be at risk for heart disease and she would like to schedule you for a follow up procedure just to be safe.

Until a few years ago, most cardiologists who had these kinds of conversations with their patients would’ve chosen to schedule their patients for an angiogram. An angiogram is a surgical procedure in which a thin tube (catheter) is inserted into a blood vessel near the groin (either the femoral artery or vein) or just above the elbow (brachial artery or vein). The catheter is then guided through the blood vessel by a surgeon to the area of the body that needs to be observed. At that point, a dye is injected into that area via the catheter to make the area highly visible to X-ray.

An angiogram, which can be used to examine blood vessels anywhere in the body, including the head and neck, is an effective method for observing the health of blood vessels, and for detecting blockages, narrowing of the arteries, and blood vessel bulges (aneurysms). Though normally safe, the procedure is not without risk, requires hospitalization, and in a small number of cases can cause a heart attack or stroke. It is also relatively expensive and, depending on the time of day in which it is performed, can result in an overnight stay in the hospital.

While an angiogram may still be required for some patients, today a growing number of cardiologists prefer to use electron beam tomography (EBT) to screen for heart disease risk. Also known as “ultra-fast CT scans,” EBT scans offer many advantages compared to angiograms. First, unlike angiograms, which require a patient to be anesthetized beforehand and then spend time in a hospital recovery room after the surgery is performed, EBT scans are completely noninvasive and can be performed in as little as 10 minutes. Instead of requiring a visit to a hospital to be performed, EBT scans are usually performed at a doctor’s clinic or radiology facility. In addition, they are much less expensive than angiograms, costing $200 to $300 on average. (Unlike angiograms, however, EBT scans are normally not covered by health insurance.)

The biggest advantage that an EBT scan offers, however, is its ability to rapidly assess the health of a patient’s heart and detect signs of heart disease very early on. For this reason, EBT is the only technology approved by the Food and Drug Administration (FDA) for the early detection of heart disease. Just as importantly, research has shown that EBT is one of the most effective ways for doctors to determine heart disease risk in patients who present with no symptoms.

The primary benefit of an EBT heart scan lies in the scan’s ability to screen for signs of calcium buildup (calcification) in the arteries. EBT scans enable doctors to accurately determine their patients’ calcium score by measuring both the amount and density of calcium deposits in the arteries. Coronary artery disease usually begins when fatty plaque starts to build up on the walls of blood vessels. As this buildup occurs, calcium deposits start to buildup at the same time, making them a marker for heart disease. For this reason, elevated coronary calcium levels strongly correlate with a higher risk for heart disease, as well as heart disease deaths. In fact, research shows that the presence of calcium deposits in arteries can increase the risk of death from heart disease by as much as 1,200 percent over seven years. Additional research has found that men with no other symptoms of heart disease who also have the highest calcium scores, have more than 10 times the risk of eventually needing heart surgery (angioplasty or bypass surgery) compared to men with low to moderate calcium scores.

EBT heart scans are especially advised for anyone who falls into one or more of the following categories:

  • People age 50 and above.
  • People who smoke.
  • People with a family history of heart disease.
  • People with elevated lipid (fat) levels.
  • People with high blood pressure.
  • People who do not exercise.
  • People who are overweight or obese.
  • People who suffer from type-II (adult-onset) diabetes.

If you feel that you are at risk for heart disease, even if you don’t have any obvious symptoms, talk with your doctor about scheduling an EBT heart scan. The procedure is not only quick, but very easy. You will simply lie on a table and be instructed to hold your breath for a few moments while the EBT scanner takes images of your heart. These images are then sent to a computer, which creates a 3D view of your heart. A second scan of your carotid arteries that run alongside your neck, delivering oxygen and nutrients to your brain, may also be performed to screen for abnormal thickness within the carotid arteries’ inner layer. No preparation, such as fasting beforehand, for the scan is required, and once it is performed, the results are available to your doctor within minutes.

Note: Despite their effectiveness for helping to prevent heart disease and heart surgery due to early detection, EBT scans cannot determine the degree of arterial narrowing if such narrowing is found. If it is, you may stillneed an angiogram in order for your doctor to assess the severity of such narrowing. In addition, EBT scans, like all forms of CT scans, exposes patients to radiation, although the amount is relatively small.