A CT Coronary Angiogram (CTCA) is a type of heart scan that checks whether the arteries that supply your heart are narrowed or blocked. It’s a non-invasive test that uses a CT scanner and a special contrast dye to take clear, 3D images of your heart’s blood vessels. If you’re at risk of heart disease or have unexplained chest pain, this scan can help spot problems early before they become serious.
Many of my patients feel nervous when a CTCA is suggested, especially if they’ve never heard of it before. But in reality, it’s one of the safest and most useful heart tests available today. I’ll walk you through exactly what the scan involves, when it’s recommended, how much it costs, and what to expect from the results.
What does a CTCA involve?
If you've been booked for a CT Coronary Angiogram, the process is more straightforward than you might think. You’ll be asked to lie flat on a scanning table, and electrodes will be attached to your chest to monitor your heart rate.
Before the scan begins, a contrast dye is injected through a vein in your arm. This helps highlight your coronary arteries on the scan. Then, as the scanner rotates around your chest, the CT machine captures detailed cross-sectional images of your heart and blood vessels.
The scan itself only takes around 10 to 20 minutes. You might need to hold your breath briefly at certain points, but there’s no pain involved just a little pressure from the IV or mild discomfort from lying still.
Why might I need a CTCA?
You might be referred for a CTCA if you have:
Chest pain or tightness
Shortness of breath on exertion
A family history of early heart disease
Abnormal ECG or stress test results
Risk factors like high cholesterol, diabetes, or high blood pressure
Even if you haven’t had clear symptoms, a CTCA may be recommended to rule out early coronary artery disease particularly in patients with a medium risk profile. It’s often used as a step before considering more invasive tests like a coronary angiogram.
Is a CTCA safe?
Yes a CTCA is considered very safe for most people. However, as with any CT scan, it involves a small amount of radiation. The radiation dose has improved significantly in recent years and is now kept as low as reasonably possible. In most cases, the benefits of early diagnosis far outweigh the minimal risk.
The contrast dye used in the scan can very rarely cause an allergic reaction or affect kidney function, especially in people with known kidney disease. Your doctor will always check this beforehand with a simple blood test.
What does the scan show?
A CTCA gives your cardiologist a clear view of:
Whether your coronary arteries are narrowed
The extent and location of any blockages
Early signs of plaque build-up
Whether further treatment or investigations are needed
It’s particularly useful for identifying subclinical atherosclerosis early narrowing of arteries that might not yet cause symptoms. This can help guide your treatment plan before things become serious.
How much does a CTCA cost?
If you’re referred through the NHS, a CTCA is free of charge. However, you may have to wait depending on urgency and availability. In many regions, waiting times range between 2 and 12 weeks.
If you go private, a CTCA typically costs between £600 and £1,200, depending on the clinic and whether consultation fees are included. Many private insurance policies cover the cost of the scan it’s worth checking your provider in advance.
What’s the difference between NHS and private scans?
The scan itself is identical whether done privately or through the NHS. The main differences are:
Waiting times - typically shorter privately
Flexibility - easier to choose appointment times privately
Speed of results - private scans often return results within 24–48 hours
Whether you go private or NHS, the scan must be justified by a cardiologist or GP based on your symptoms or risk profile.
Are there different types of heart scans?
Yes. CTCA is just one type of imaging. Other common heart scans include:
Type of Scan | What It Shows | Involves Radiation? |
CT Coronary Angiogram (CTCA) | Coronary artery blockages | Yes |
Heart valves and muscle function | No | |
Cardiac MRI | Heart structure and tissue damage | No |
Nuclear stress test | Blood flow to the heart muscle | Yes |
Each test has its own strengths. Your cardiologist will choose the most appropriate one based on your symptoms and medical history.
When should I get a heart scan?
You should consider speaking to your doctor about a CTCA if:
You experience chest pain, pressure, or discomfort
You’ve noticed breathlessness or fatigue on light exertion
You have high cholesterol, high blood pressure, or diabetes
You have a strong family history of heart problems
Your doctor has picked up abnormal results on a blood test or ECG
A scan isn’t always the first step but it can be an excellent tool if there's uncertainty about your diagnosis or future risk.
What happens after the scan?
Once the scan is complete, the images are reviewed by a cardiac radiologist and sent to your cardiologist. This usually happens within a few days or even the same day in private settings.
Your doctor will then explain the results. If everything looks normal, that’s reassuring. If mild plaque is found, you may be advised to make lifestyle changes and possibly start medication such as statins. If moderate or severe narrowing is detected, you might be referred for further tests, such as a functional stress test or a traditional coronary angiogram.
Summary
As someone who works closely with patients exploring their heart health, I can say that CT Coronary Angiograms have become one of the most effective ways of spotting early signs of heart disease. They’re quick, non-invasive, and can provide life-saving insight.
If you’re unsure whether this test is right for you, speak with your GP or a cardiologist. Whether you go through the NHS or a private provider, the decision should be based on your symptoms, risk factors, and the potential benefit the scan could bring.
We think understanding your heart is the first step to protecting it and CTCA is a modern, reliable way to do just that.
