Modern cardiac CT can rapidly image coronary anatomy and help rule out or characterize obstructive coronary artery disease in selected patients. DHZC uses high-performance cardiovascular CT and explicitly states that CT should be selected according to clinical risk rather than used as a general preventive examination.
CCTA answers an anatomical question
CCTA shows coronary anatomy and plaque/stenosis. It differs from functional imaging such as stress CMR or PET, which evaluates whether disease causes myocardial ischemia. Sometimes both anatomical and functional information are needed.
Current ESC diagnostic pathway
The 2024 ESC chronic-coronary-syndrome guidance recommends CCTA to diagnose obstructive CAD and estimate risk in suitable patients with suspected disease and low-to-moderate pre-test clinical likelihood. Patients with very high likelihood, severe symptoms or high-risk findings may need invasive angiography instead.
Contrast and radiation matter
DHZC notes that CT uses X-rays and often iodinated contrast for angiography. Severe renal impairment, untreated hyperthyroidism, contrast allergy and pregnancy can affect suitability and should be disclosed before scheduling.
What to send before a German CCTA review
Provide enough information to decide whether CT is the right next test.
- Symptoms and cardiovascular risk factors
- Recent ECG and echocardiogram
- Previous stress testing
- Prior coronary CT or invasive angiography
- Kidney function and thyroid status when requested
- Contrast-allergy history
- Current heart-rate and rhythm medication
An abnormal CCTA does not automatically mean stenting
If CT shows coronary disease, the next step depends on stenosis severity, symptoms, ischemia and overall risk. Additional functional testing or invasive physiological assessment may be needed before a revascularization decision.
Official sources
Sources last checked 2026-08-29. Diagnostic indications and preparation requirements can change, so confirm current instructions with the imaging center before travelling.