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Patient guide · Cardiac imaging

CT coronary angiography, the non-invasive first-line test for chest pain — NICE CG95.

If you’ve been sent for a CTCA, it’s usually because your cardiologist wants to look at your coronary arteries without a catheter — a few seconds of gated CT with iodinated contrast, done through a single breath-hold. Privately in London, most patients get a same-week appointment and a consultant report inside 48 hours, with CT-FFR or CaRi-Heart AI plaque analysis added only when an intermediate finding actually needs it.

See indicative pricing
A cardiac radiologist reviewing a CT coronary angiogram in a private London clinic

Why patients choose us

  • 01

    The right hands

    We route you to a consultant cardiac radiologist — the person who scans you and reports it decides the answer.

  • 02

    Often answers same-day

    Findings can frequently be discussed immediately, with the written report within 24–48 hours.

  • 03

    Independent, and free

    We are paid by no clinic, so the recommendation is impartial and costs you nothing.

Key facts

CTCA in six lines.

What a CT coronary angiogram is, how it is done, and where its answers come from.

  • 01

    Around ten minutes on the table

    The actual scan takes seconds; the full visit — cannula, beta-blocker, GTN, breath-hold acquisition — is usually inside 30 minutes.

  • 02

    NICE CG95 first-line

    Recommended as the first-line test for stable chest pain of possible cardiac origin.

  • 03

    Beta-blocker to slow the heart

    Oral or IV beta-blocker often given to lower heart rate to under 65 bpm for a diagnostic scan.

  • 04

    Sub-millimetre resolution

    Modern scanners image the coronary lumen and plaque at sub-millimetre resolution.

  • 05

    CT-FFR add-on

    CT-derived fractional flow reserve quantifies the functional significance of a stenosis.

  • 06

    Low radiation dose

    Typical dose is around 2–5 mSv on modern scanners — comparable to a year of background radiation.

Indicative pricing

What a private CTCA costs in London.

Indicative ranges across our partner clinics. Send the details and we quote firm figures across two or three options.

In short

A standard CTCA in our network: £800–£1,400, with a consultant report within 24–48 hours.

Scan type Indicative range
Standard CT coronary angiography (CTCA) £800–£1,400
CTCA with coronary calcium score £900–£1,600
CTCA with CT-FFR (HeartFlow) £1,500–£2,400
CTCA with CaRi-Heart AI plaque analysis £1,600–£2,600
CTCA + cardiology consultation £1,200–£2,000
Full chest-pain work-up (CTCA + bloods + ECG) £1,400–£2,400

Prices vary by clinic, scanner generation and whether CT-FFR or CaRi-Heart is added. We come back with a firm quote within one working day.

Preparation and diagnosis

From consultation to report — what happens, in order.

A CTCA is a short scan, but the preparation matters — this is the sequence we follow.

  1. 01

    Before

    Cardiology consultation

    A consultant cardiologist reviews your symptoms, risk factors and prior imaging, and confirms CTCA is the right first test under NICE CG95.

  2. 02

    Before

    Withhold caffeine 12 hours

    No coffee, tea, energy drinks or chocolate for 12 hours before the scan — caffeine raises heart rate and degrades image quality.

  3. 03

    Before

    Oral or IV beta-blocker

    A beta-blocker is given, oral or intravenous, to bring your heart rate under 65 bpm for a diagnostic-quality scan.

  4. 04

    On the day

    Sublingual GTN before scan

    A single sublingual glyceryl trinitrate spray or tablet dilates the coronaries just before acquisition.

  5. 05

    On the day

    ECG-gated CT with IV contrast

    A cannula delivers iodinated contrast while the CT acquires ECG-gated images through a single breath-hold — the scan itself takes seconds.

  6. 06

    After

    Optional CT-FFR post-processing

    If a stenosis is identified, the images can be sent for CT-FFR (HeartFlow) or CaRi-Heart AI plaque analysis.

  7. 07

    After

    Cardiology report in 24–48 hours

    A consultant cardiac radiologist issues the written report within 24–48 hours, with an onward cardiology plan.

Typical end-to-end: 3–7 days. Urgent cases: same day.

What it shows

What a CTCA can — and can’t — answer.

CTCA quantifies plaque, stenosis and calcium; with CT-FFR it also quantifies functional significance. These are the eight findings that most often decide the next step.

  • Non-obstructive coronary plaque

    Detects atherosclerotic plaque before it narrows the lumen — a driver of long-term risk.

  • Obstructive coronary stenosis

    Quantifies narrowing of the coronary lumen and its distribution.

  • Coronary calcium score

    Agatston score from the non-contrast series — a decades-of-risk marker.

  • CT-FFR pressure drop

    Simulated fractional flow reserve across a stenosis — functional, not just anatomical.

  • Anomalous coronary artery

    Congenital origin or course variants that matter for sport and surgery.

  • Coronary bypass graft patency

    Confirms whether CABG grafts are open, narrowed or occluded.

  • Left main disease

    Identifies critical left-main stem stenosis — a prognostic red flag.

  • Red flag: severe left-main or triple-vessel disease — urgent cardiology / surgical MDT

    Findings escalated the same day to a cardiology and cardiac-surgery MDT.

Treatment and next steps

What follows a CTCA result.

From reassurance and medical therapy through PCI and CABG — the concrete pathways the report can lead to.

  • Reassurance for a normal CTCA

    A normal CTCA has an excellent negative predictive value — most patients need no further cardiac investigation.

  • Optimal medical therapy

    Statin, aspirin, beta-blocker and ACE inhibitor as indicated, targeted to your risk profile.

  • Invasive coronary angiography ± FFR

    Catheter-based angiography with pressure-wire assessment when CTCA suggests significant disease.

  • Percutaneous coronary intervention (PCI)

    Stenting of a flow-limiting lesion, guided by anatomy and CT-FFR / invasive FFR.

  • Coronary artery bypass graft (CABG)

    Surgical revascularisation for left-main, triple-vessel or complex disease, decided by the heart-team MDT.

  • Cardiovascular risk-factor optimisation

    Blood-pressure, lipid, glucose and lifestyle targets — the largest lever for long-term outcome.

  • Cardiac rehabilitation

    Structured exercise and education after PCI, CABG or a significant new diagnosis.

  • Structured cardiology follow-up

    Scheduled review with your consultant cardiologist, with repeat imaging where clinically indicated.

Our vetted London network

A small panel of clinics, we picked them.

Partners across central, north, west and south London. Not listed publicly — introductions are made privately, once we understand your case.

Selection criteria

How we choose every clinic in our network.

A modern London cardiac CT suite with a current-generation multi-slice scanner
Consultant cardiac radiologists

  • Consultant cardiac radiologists reporting all CTCA studies

  • Modern 128-slice-plus scanners with prospective ECG gating

  • HeartFlow CT-FFR and CaRi-Heart AI plaque analysis available

  • Onward cardiology and cardiac-surgery MDT pathway if significant disease is found

Red flags

The findings that change the plan today.

A short list of CTCA findings that trigger urgent cardiology escalation, MDT discussion or on-site management.

  • Severe left-main disease

    Critical stenosis of the left-main stem — urgent cardiology and cardiac-surgery MDT.

  • Triple-vessel disease

    Significant disease in all three coronary territories — urgent heart-team discussion.

  • Very high calcium score with symptoms

    Agatston well into the high-risk range with typical angina — escalate to cardiology.

  • Anomalous coronary origin

    Congenital origin variants with interarterial or intramural course — sports and surgical implications.

  • Coronary artery dissection

    Spontaneous coronary artery dissection — acute cardiology admission.

  • Acute coronary syndrome on scan

    Findings consistent with ACS — same-day transfer to a cardiac unit.

  • Post-stent restenosis

    In-stent restenosis after PCI — cardiology review for repeat intervention.

  • Post-CABG graft failure

    Occluded or severely diseased bypass grafts — cardiology and cardiac-surgery review.

  • Contrast anaphylaxis

    Severe reaction to iodinated contrast — managed on-site with escalation as needed.

Reading your report

A CTCA report can look intimidating. It isn’t.

Whatever the finding, the report keeps to the same four parts.

A consultant cardiac radiologist reviewing CT coronary angiography images on a clinical workstation at a UK private clinic

A quiet reminder

The report is written for your doctor, not for you — and that’s normal.

If you would like us to talk you through it before your follow-up, just ask.

  1. 01 Header

    Indication and risk factors

    Your details, the reason for the scan, and the cardiovascular risk factors that shape interpretation.

  2. 02 Technique

    Protocol, dose and gating

    Scanner, prospective or retrospective ECG gating, contrast volume and effective radiation dose in mSv.

  3. 03 Findings

    Calcium score, plaque and stenosis

    Vessel-by-vessel description: Agatston score, plaque burden and morphology, and CAD-RADS stenosis grade.

  4. 04 Impression

    The conclusion: read this first

    Normal, non-obstructive, obstructive or high-risk disease — with the concrete next step.

Recognised by major UK insurers

BupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealixBupaAXA HealthVitalityAvivaWPACignaHealix

Cover depends on your policy and clinic; we confirm with your insurer before booking.

Frequently asked

Everything we get asked about CTCA.

Quick answers on preparation, radiation dose, CT-FFR, CaRi-Heart, and what a normal scan means.

  • How long does a CT coronary angiogram take?

    The scan itself is a single breath-hold of a few seconds. Add cannulation, a beta-blocker to slow your heart rate below 65 bpm, and a spray of GTN, and most people are in and out of the imaging suite in around 30 minutes.

  • Why do I need a beta-blocker before the scan?

    CTCA image quality is best when your heart rate is under 65 bpm during acquisition. An oral or intravenous beta-blocker is used to bring the rate down safely for the scan and is stopped afterwards.

  • How much radiation does a CTCA involve?

    A typical modern CTCA delivers around 2–5 mSv — broadly comparable to a year of natural background radiation in the UK, and far lower than earlier-generation coronary CT.

  • What is CT-FFR and when is it added?

    CT-FFR (for example HeartFlow) uses the CTCA images to simulate the pressure drop across a stenosis, giving a functional read-out alongside the anatomy. It is added when a lesion of intermediate severity needs functional assessment before deciding on invasive angiography or PCI.

  • What is CaRi-Heart plaque analysis?

    CaRi-Heart is an AI-based analysis of pericoronary fat attenuation on CTCA that reports a residual cardiovascular risk score. It is an add-on to standard CTCA reporting, not a replacement for it.

  • What happens if my CTCA is normal?

    A normal CTCA has an excellent negative predictive value — the great majority of patients with a normal CTCA and typical chest pain need no further cardiac investigation, and are managed with reassurance and cardiovascular risk-factor optimisation.

Sources

The guidance behind this page.

Reviewed by Pulse Atlas Editorial Board, . Last reviewed 2026-07-30. Next review 2027-07-30.

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In practice, in London

The honest picture around CT coronary angiography in London

With CT coronary angiography, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. Public provision for CT coronary angiography is competent but constrained by capacity. Private London clinics tend to have shorter diaries and longer appointment slots, so you get the same specialists with more time. For people who’ve been going round in circles with primary care, that first proper conversation is often what shifts things.

A typical private booking for CT coronary angiography in London starts with a consultant conversation — sometimes in person on Harley Street or Marylebone, sometimes on video if that suits better. Any imaging or diagnostics happen at a nearby CQC-registered facility, and reports usually land within 24 to 72 hours. The whole loop, from first call to written report, is often done inside a fortnight. For CT coronary angiography specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.

Fit matters more than people expect. For CT coronary angiography, the right consultant depends on what you actually need — a second opinion, a definitive diagnosis, a bridge into treatment, or reassurance that nothing’s being missed. We match on that, not on who has the biggest brochure. If a test isn’t the right next step, we’ll say so before you book anything.

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