Cardiac imaging · London
Coronary CT angiography (CCTA) - private in London
The modern first-line scan for chest pain. A ten-minute, non-invasive look at every coronary artery, reported by a consultant cardiac radiologist within 24 to 72 hours. From £750 across a small vetted London network.
What CCTA is
A contrast CT that maps every coronary artery.
NICE guideline CG95 makes CCTA the first-line test for adults with stable chest pain of suspected cardiac origin. It has replaced the exercise ECG for most patients under 65.
Coronary CT angiography is a contrast-enhanced CT scan of the heart, ECG-gated so the images are captured in the same fraction of the cardiac cycle every time. Iodinated contrast injected into an arm vein reaches the coronary arteries within seconds, lighting them up against the surrounding muscle. The scanner then acquires a full three-dimensional dataset of the coronary tree in a single breath-hold.
What separates CCTA from a plain CT calcium score is that it shows the artery wall itself, not just the calcium in it. That means the reporting cardiac radiologist can see soft, non-calcified plaque, grade any narrowing, and assess the origin, course and patency of every major branch. In modern practice the scan is reported using CAD-RADS 2.0, a structured system that translates what the radiologist sees into a clear next step for you and your cardiologist.
Who it is for
The people who benefit most.
CCTA is at its most powerful in intermediate-risk patients, where a clean scan meaningfully changes the plan.
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Typical or atypical chest pain
The classic NICE indication. New chest tightness, breathlessness on exertion, or pain that worsens with effort.
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Ruling out coronary disease
When the clinical picture is unclear, an excellent negative predictive value gives you a genuine all-clear.
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Pre-operative cardiac risk
Before non-cardiac surgery in patients with risk factors and reduced exercise tolerance.
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After an abnormal calcium score
A calcium score of 100 or above, or worrying stress-test result, is a strong reason to go on to CCTA.
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Family history of early CAD
A first-degree relative with a heart attack under 55 (men) or 65 (women), especially with your own risk factors.
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Bypass graft or stent follow-up
To confirm bypass grafts remain patent, or to look at large-calibre stents in symptomatic patients.
Preparation
What to do the day before, and the morning of.
A slow, steady heart rate is the single biggest determinant of image quality. Everything below is aimed at that.
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Heart rate under 65 bpm
A steady, slow heart rate gives the sharpest coronary images. Most patients are given oral or intravenous beta-blockers on arrival.
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No caffeine for 24 hours
Coffee, tea, energy drinks and dark chocolate all raise heart rate and blunt beta-blockers. Water is fine.
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Light meal, not fasted
Eat something small a few hours before. A completely empty stomach can make nausea worse with contrast.
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Cannula for contrast
A small line goes into a vein in the arm for iodinated contrast, which lights up the coronary arteries.
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Sublingual GTN spray
A dose of glyceryl trinitrate under the tongue just before scanning dilates the coronary arteries and improves image quality.
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Bring your medication list
Tell the team about beta-blocker allergies, severe asthma, sildenafil use in the last 48 hours, or known contrast reactions.
The scan itself
Ten to twenty minutes, most of it preparation.
The actual imaging is a single breath-hold of a few seconds. Everything else is setup.
You lie on your back on the CT table with ECG leads placed on your chest so the scanner can time acquisition to your heartbeat. If your heart rate is still above 65 beats per minute, an intravenous beta-blocker is titrated in until it settles. Two puffs of glyceryl trinitrate go under the tongue about three minutes before the scan to dilate the coronary arteries and open them up on the images. The contrast injection is timed to arrive in the aortic root at the moment of scanning; you may feel a warm flush and a metallic taste for a few seconds.
Radiation dose on modern third-generation dual-source and wide-detector scanners is typically 3 to 5 millisieverts, comparable to about eighteen months of natural background exposure in the UK and considerably less than an invasive diagnostic angiogram. Prospective ECG-triggering and iterative reconstruction have dropped doses by more than 80 per cent compared with the equipment of a decade ago. You go home immediately afterwards, drive as normal, and can eat and drink straight away.
What it detects
Anatomy, plaque, flow.
A structured CAD-RADS 2.0 report covers the following, artery by artery.
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Calcified plaque
Hard calcium deposits in the coronary wall, quantified alongside a full CT calcium score.
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Non-calcified (soft) plaque
The higher-risk fatty plaque that a calcium score alone cannot see.
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Stenosis grading
Percentage narrowing of each major artery, reported using the CAD-RADS 2.0 system.
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Coronary anomalies
Congenital variants in the origin or course of the coronary arteries, important before sport or surgery.
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Bypass graft patency
Whether previous coronary artery bypass grafts are still open and flowing.
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TAVI and structural planning
Precise measurements of the aortic root, annulus and access vessels before valve intervention.
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FFR-CT (where offered)
A computational fractional flow reserve derived from the same dataset, showing whether a narrowing is actually restricting flow.
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Incidental chest findings
Lungs, aorta and pericardium are reviewed on the same acquisition.
Cost in London
All-inclusive of consultant reporting.
Indicative ranges across our vetted London network. We come back with a firm quote for two or three named clinics within one working day.
| Scan type | Indicative range | Report turnaround |
|---|---|---|
| Coronary CT angiography (CCTA), standard | £750 – £1,100 | 24–48 hrs |
| CCTA with calcium score bundle | £850 – £1,250 | 24–48 hrs |
| CCTA with FFR-CT analysis (where indicated) | £1,100 – £1,400 | 3–5 days |
| Cardiology consultation to review results | £200 – £350 | Same visit |
Bupa, AXA Health, Vitality, Aviva, WPA, Cigna and Healix all recognise CCTA when it is medically indicated and pre-authorised. We handle the pre-authorisation with your insurer before the appointment is confirmed.
CCTA vs invasive angiogram
The right test at the right time.
CCTA rules coronary disease out. Invasive angiography confirms and treats. Modern pathways use them in that order.
| CCTA | Invasive coronary angiogram | |
|---|---|---|
| Invasiveness | Non-invasive; IV cannula only | Invasive; catheter via wrist or groin |
| Setting | Outpatient, in and out in an hour | Day-case, requires recovery bay |
| Radiation dose | ~3–5 mSv with modern low-dose protocols | ~5–7 mSv typical diagnostic study |
| What it shows | Anatomy and plaque, calcified and soft | Anatomy plus live pressure and flow, allows PCI |
| Negative predictive value | >99% for excluding significant disease | Definitive but rarely needed if CCTA is clean |
| Treatment in one visit | No; a further procedure is needed to treat | Yes; stenting can be done at the same time |
| Typical cost (private London) | £750–£1,400 | £4,500–£8,000+ |
The negative predictive value of a modern CCTA is above 99 per cent. A clean scan effectively excludes obstructive coronary artery disease and, in most patients, avoids the need for an invasive procedure altogether. A positive scan is not the end of the pathway; it usually leads to a discussion about medical therapy, further functional testing, or a day-case invasive angiogram with a view to stenting.
Where it is done
The London CCTA network we use.
Each is CQC-registered and reports through a consultant cardiac radiologist, not a general body radiologist.
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Chelsea
Royal Brompton (Private Care)
National centre for cardiothoracic imaging with sub-specialist cardiac CT reporting.
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London Bridge
HCA London Bridge Hospital
Third-generation dual-source CT, same-day consultant read for urgent chest pain.
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St John's Wood
HCA The Wellington Hospital
High-volume cardiac CT service, direct pathway to cardiologist review.
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Kensington
Cromwell Hospital (Bupa)
Low-dose protocols, evening and Saturday slots for working patients.
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The City
Bart's Heart Centre Private
Europe’s largest heart centre; CCTA reported by imaging cardiologists.
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Marylebone
OneWelbeck Heart Health
Consultant-led diagnostic hub, FFR-CT available on selected scans.
Related
Adjacent tests and treatments.
What we typically pair with CCTA, and what usually follows a positive result.
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CT coronary calcium score
The quick, contrast-free screening test often paired with CCTA in one visit.
Read more -
Cardiac MRI
Best for heart muscle, scarring and function; no radiation.
Read more -
Stress echocardiogram
A functional alternative when contrast or radiation is a problem.
Read more -
Angioplasty and stents
The usual next step after a significant narrowing is confirmed.
Read more -
Atrial fibrillation
Rhythm disturbance that often coexists with coronary disease.
Read more
Frequently asked
What patients ask before booking a CCTA.
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I am claustrophobic. Will I cope with a CT coronary scan?
CCTA uses a short, open ring rather than a tunnel. Your head stays outside the machine and the whole scan lasts around ten to twenty minutes, with the actual image capture taking only a few seconds. Most patients who struggle with MRI find CT completely straightforward. If you are still anxious, we can arrange a mild oral sedative for the appointment.
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What if I have a contrast allergy?
A previous mild reaction to iodinated contrast is not usually a barrier. The team will pre-medicate you with steroids and antihistamines, and you will be observed for a short period afterwards. A previous severe anaphylactic reaction is a genuine contraindication, and we will look at a stress cardiac MRI or a nuclear perfusion study instead.
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What kidney function do I need for the contrast?
You need a recent eGFR, typically above 45 for a straightforward outpatient CCTA. Below that we discuss with the reporting radiologist and may reduce the contrast dose, hydrate you before and after, or switch you to a non-contrast option such as a calcium score alone.
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My resting heart rate is over 80. Can I still be scanned?
Yes. Oral beta-blockers are given about an hour before the scan and topped up intravenously on the CT table if needed. If your heart rate genuinely will not slow, or beta-blockers are contraindicated, the team will use a wide detector scanner and multi-beat acquisition to still get diagnostic images.
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Will my private medical insurance cover CCTA?
CCTA is well recognised by Bupa, AXA Health, Vitality, Aviva, WPA, Cigna and Healix when it is medically indicated for chest pain or cardiac risk assessment. You will normally need a referral from a GP or cardiologist and a pre-authorisation code. Screening in an asymptomatic person is usually self-pay.
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What happens if the scan shows a significant narrowing?
A CAD-RADS 3, 4 or 5 result goes straight to a cardiologist, usually the same day the report is signed. Depending on the anatomy and your symptoms, the next step is either optimised medical therapy, a functional test such as stress MRI, or an invasive coronary angiogram with a view to stenting. We coordinate that onward pathway with you.
Concierge cardiac imaging
Get matched with the right London CCTA clinic, in one working day.
Tell us your symptoms, referral and insurer. We come back with two or three named options, firm prices and the earliest slot on our vetted panel. Free, and independent by design.