With a long experience of more than ten years in the advanced methods of cardiovascular imaging (CT Coronary Angiography - Cardiac MRI - Stress Cardiac MRI) and several thousand tests, the Department of Cardiovascular Imaging of St. Luke's Hospital, led by the Specialist Radiologist Mr. Alexandros Kallifatidis, plays a leading role in the diagnostic approach and testing of cardiovascular diseases in Greece and the wider Balkan region, operating in the standards of similar international specialised centres of cardiovascular imaging.

Cardiac Computed Tomography - CT Coronary Angiography

Cardiac Computed Tomography - CT Coronary Angiography is a non-invasive (bloodless) examination of coronary vessels with high diagnostic accuracy.

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Coronary Angiography CT - Cardiac CT Scan Indications:

Cardiac Computed Tomography - CT Coronary Angiography is indicated both for the prevention (serious hereditary history, in asymptomatic patients based on risk factors), and diagnosis in a number of cases, such as:

• Chest pain in people with little or intermediate probability for coronary artery disease
• In patients without known coronary artery disease, presenting typical or atypical chest pain.
  
• Non-cardiac chest pain, combined with a pathological resting cardiogram
• Newly emerging heart failure without previously known coronary artery disease
• Clarification of ambiguous stress tests
• Coronary abnormalities

In summary, other Cardiac CT Scan - CT Coronary Angiography indications are the following:

• Checking the bypasses graft and stents
• Functional Study of Heart-3D Imaging
• Complications of infarction- Checking for intra-abdominal clots
• Valvular heart diseases
  
• Pericardium Diseases
• Pulmonary veins assessment before ablation
• Checking for tumours or tumour-like lesions
• Diseases of the aorta
• Checking for congenital heart disease
• Measurements before TAVI (transcatheter aortic valve implantation) and TPVI (transcatheter pulmonary valve implantation)
• Triple rule out technique with which we can rule out emergency situations

Heart MRI - Stress MRI

The heart MRI contributes decisively to the diagnosis of many diseases, both of ischaemic and non-ischaemic aetiology. It is particularly useful in the detailed assessment of the anatomy and morphology of the heart; in addition, it provides valuable functional information. It is the gold standard technique for estimating the various parameters of the heart.

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Cardiac MRI Indications

• Diagnosis of Cardiomyopathies
• Diagnosis of Myocarditis
• Diagnosis of coronary heart disease
• Detection of acute or old infarction and myocardial viability testing
• Detection of complications of infarction
• Stress Cardiac MRI for the bloodless emergence of myocardial ischaemia with special protocols and high diagnostic accuracy, without radiation (unlike heart scintigraphy)
• Valvular diseases (Anatomy, Stenosis, Insufficiency)
• Congenital heart disease
• Tumours and tumour-like lesions of the heart
• Aortic diseases
• Check for abnormal coronary outgrowth of the coronary vessels
• Pulmonary Hypertension
• Pericardium Diseases
• Pulmonary veins assessment before ablation
• Estimation for Cardiac Shunt and Qp:Qs calculation

Stress Cardiac MRI – One stop shop technique

Stress Cardiac MRI is the Cardiac MRI, in which a pharmaceutical substance that causes controlled fatigue (Stress) of the myocardial is administered with a specific protocol and dosage, in order to examine the adequacy of its haematosis, so as to confirm or exclude the case of myocardial ischaemia.

Cardiac Stress MRI Indications

• Assessment of intermediate coronary artery stenosis
  
• Estimation of complex stenosis
• After myocardial infarction before revascularization operations (PCI, bypass surgeries)
• Myocardial viability check
• In cases of suspected chest discomfort or in patients of intermediate or high risk for coronary artery disease

Also, cardiac stress MRI is indicated if there are new symptoms or worsening symptoms in patients:

• with Calcium Score > 100
• aged 40 years or older with known diabetes mellitus
• with difficulty in adjusting pressure
• with suspicion or signs of ventricular tachycardia
• with microvascular disease
• with inability to assess ECG for ischaemia as in cases of LBBB
• with physical inability to perform a stress test

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