Patient guide · Cardiac imaging
CT coronary artery scan (CTCA), the modern first-line scan for chest pain — a patient guide.
The CT coronary artery scan (CTCA) is a low-dose gated CT with IV contrast that visualises the coronary arteries and the extent of plaque. Modern add-ons include CT-FFR (HeartFlow) for functional assessment and CaRi-Heart AI for perivascular inflammation.
Why CTCA, and why now
- 01
A modern first-line scan
NICE CG95 recommends CT coronary artery scanning as the first investigation for stable chest pain — before treadmill or invasive angiogram.
- 02
Reader-first pathway
A consultant cardiac radiologist scans and reports — with CT-FFR (HeartFlow) or CaRi-Heart AI added when the clinical question warrants it.
- 03
Fast, low-dose, seconds long
The scan itself lasts seconds. Radiation is typically 2–5 mSv on modern scanners. Appointment: about an hour.
Key facts
CTCA at a glance.
Six facts to anchor the rest of this page — the definition, the guideline position, the modern add-ons, the radiation dose, and the time on the day.
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Definition
A gated CT with IV contrast that images the coronary arteries and the extent of plaque.
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NICE first-line
CG95 places CTCA first-line for stable chest pain of suspected cardiac origin.
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CT-FFR add-on
HeartFlow adds functional assessment — does a given stenosis actually restrict flow?
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CaRi-Heart AI
Perivascular fat attenuation index (FAI) profiles coronary inflammation.
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Radiation
Typically 2–5 mSv on modern low-dose scanners — comparable to background over a year or two.
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Time on the day
Scan takes seconds. Full appointment ~1 hour, including cannula, beta-blocker window and imaging.
Indicative pricing
What a private CTCA costs in London.
Indicative ranges across our partner clinics. Add-ons like CT-FFR (HeartFlow) and CaRi-Heart AI carry their own separate fees.
In short
A standard CTCA in our network: £650–£950, with the written report typically in 24–48 hours.
| Scan type | Indicative range | Typical duration | Report turnaround |
|---|---|---|---|
| CT coronary artery scan (CTCA) | £650–£950 | 60 min | 24–48 hr |
| CTCA + calcium score | £750–£1,100 | 60 min | 24–48 hr |
| CTCA + CT-FFR (HeartFlow) | £1,400–£2,200 | 60 min | 3–5 days |
| CTCA + CaRi-Heart AI (FAI) | £1,500–£2,400 | 60 min | 5–7 days |
| CTCA + cardiology consultation | £950–£1,600 | 90 min | Same visit |
| Full chest-pain work-up (CTCA + bloods + ECG + consult) | £1,400–£2,400 | Half-day | Same-week |
Prices vary by scanner, whether a calcium score, CT-FFR (HeartFlow) or CaRi-Heart AI analysis is added, and whether a same-visit cardiology consultation is included.
Preparation
From referral to report — what happens, in order.
The scan itself takes seconds. Most of the appointment is preparation — cannula, beta-blocker, sublingual GTN — so that the images are clean.
Phase 1 · Before
Referral and 12-hour caffeine washout
Phase 2 · On the day
~1 hour at the clinic
Phase 3 · After
Post-processing add-ons
- 01
Before
Cardiology referral
A cardiologist or GP referral, with symptom description and risk factors. We can arrange a fast-track private cardiology consult if needed.
- 02
Before
Withhold caffeine 12 hours
No coffee, tea, energy drinks or chocolate for 12 hours before the scan — caffeine raises heart rate and blurs the images.
- 03
Before
Oral beta-blocker to slow the heart
A single oral beta-blocker on arrival to bring the resting heart rate below 65 bpm, so the coronary arteries can be frozen in mid-diastole.
- 04
On the day
Sublingual GTN before the scan
A spray of sublingual glyceryl trinitrate dilates the coronary arteries, improving image quality of small distal vessels.
- 05
On the day
IV cannula and contrast
A cannula in the arm delivers iodinated contrast, timed to the coronary phase — you feel a warm flush that passes in seconds.
- 06
On the day
The scan itself — seconds long
A single breath-hold, ECG-gated acquisition. The scan itself takes only a few seconds.
- 07
After
Post-processing for CT-FFR / CaRi-Heart
Datasets can be sent to HeartFlow for CT-FFR or to CaRi-Heart for perivascular inflammation analysis, if requested by your cardiologist.
Typical end-to-end: 3–7 days. Urgent cases: same week.
What it shows
What a CTCA actually answers.
CTCA characterises stenosis, plaque, calcium, and — with add-ons — functional flow and inflammation. Here is the anatomy of the answer.
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Coronary artery lumen (stenosis %)
The degree of narrowing in each coronary segment, graded by CAD-RADS.
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Plaque type — calcified vs soft
Distinguishes stable calcified plaque from higher-risk soft or mixed plaque.
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Segment-level disease burden
A per-segment description across LAD, LCx, RCA and their branches.
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CT-FFR pressure drop across a stenosis
Functional flow reserve derived from the CT dataset — does this narrowing actually restrict flow?
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Bypass-graft patency
Assesses patency of prior CABG grafts (LIMA, radial, saphenous) and native progression.
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Coronary anomaly
Anomalous origin or course — clinically important in athletes and younger patients.
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CaRi-Heart FAI (inflammation)
Perivascular fat attenuation index — a validated marker of coronary inflammation and future event risk.
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Red flag: left-main or triple-vessel disease — urgent cardiology / surgical review
Left-main stenosis or three-vessel disease is escalated immediately for cardiology and cardiothoracic surgery review.
Variants & next steps
Not all CTCA studies are the same.
The variants we book, and the next-step pathways they typically lead to.
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Standard CTCA
Gated CT with contrast — coronary lumen, plaque and calcium in a single scan.
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CTCA + calcium score
Adds Agatston calcium quantification for risk stratification.
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CTCA + CT-FFR (HeartFlow)
Functional flow reserve derived from the CT dataset — decides whether a stenosis needs the cath lab.
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CTCA + CaRi-Heart AI
Perivascular inflammation profiling (FAI) — a research-grade layer of future-risk data.
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CTCA post-bypass
Assessment of CABG graft patency and native disease progression.
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CTCA for coronary anomaly
Focused work-up for suspected anomalous coronary origin in athletes or younger patients.
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CTCA + cardiology consult
Same-visit consultant cardiology opinion and management plan.
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Urgent same-week CTCA
Expedited slot for symptomatic patients needing a rapid answer.
Reassurance — normal CTCA
A CAD-RADS 0 study effectively excludes obstructive coronary disease.
Optimal medical therapy
Statins, antiplatelets, blood-pressure control — the foundation of any pathway.
CT-FFR functional workup
HeartFlow for intermediate stenoses — avoids unnecessary cath-lab visits.
Invasive angiography + FFR
When CT-FFR or symptoms warrant it, the cath lab confirms and treats.
PCI (stenting)
Percutaneous coronary intervention for suitable stenoses.
CABG (bypass surgery)
Surgical bypass for left-main or complex triple-vessel disease.
Cardiovascular risk optimisation
Lipids, glucose, blood pressure, weight, smoking — the modifiable levers.
Cardiology follow-up
Structured review of symptoms and imaging on a defined cadence.
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.
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Consultant cardiac radiologists, current-generation low-dose CT scanners
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CAD-RADS reporting and standardised segment-level description
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CT-FFR (HeartFlow) and CaRi-Heart AI pathways available where indicated
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Onward cardiology or cardiothoracic surgery route if significant disease is found
Red flags & safety
What we escalate immediately.
CTCA is exceptionally safe as an elective test — but there are findings and situations that need same-day cardiology or A&E, not a private slot.
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Left-main stenosis
Significant left-main coronary disease — urgent cardiology and cardiothoracic surgical review.
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Triple-vessel disease
Significant disease across LAD, LCx and RCA — often a CABG conversation.
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Very high calcium score
Agatston well above age-and-sex expectation — escalates preventative therapy intensity.
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Anomalous coronary origin
Interarterial or malignant course — needs specialist review, particularly in athletes.
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Coronary dissection
Spontaneous coronary artery dissection — urgent cardiology assessment.
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Post-stent restenosis
In-stent restenosis on surveillance CTCA — cardiology and possible invasive work-up.
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Contrast-induced kidney injury
A recognised risk in patients with impaired baseline renal function — pre-scan bloods and hydration protocols apply.
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Contrast anaphylaxis
Rare but real — always disclose prior contrast reactions before booking.
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Rapidly progressive symptoms despite therapy
Escalating chest pain on optimal medical therapy — do not wait for a private slot; call 999 or attend A&E.
Reading your report
A CTCA report can look intimidating. It isn’t.
Whatever the finding, the report keeps to the same four parts.
A quiet reminder
The report is written for your cardiologist, not for you — and that’s normal.
If you would like us to talk you through it before your follow-up, just ask.
- 01 Header
Indication and risk profile
Your details, presenting symptoms, and cardiovascular risk factors that shape interpretation.
- 02 Technique
Scanner, gating and radiation dose
The acquisition protocol, heart rate at the time of the scan, and the effective radiation dose in mSv.
- 03 Findings
CAD-RADS by segment, plaque, calcium
Per-segment CAD-RADS grade, plaque morphology, Agatston score, and any CT-FFR or FAI results.
- 04 Impression
The conclusion: read this first
Overall disease burden, whether functional testing or invasive angiography is needed, and the concrete next step.
Recognised by major UK insurers
Cover depends on your policy and clinic; we confirm with your insurer before booking.
Frequently asked
Everything patients ask about CTCA.
Quick answers on CTCA vs calcium score, CT-FFR, CaRi-Heart, radiation, and when to skip a private slot for A&E.
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What is a CT coronary artery scan (CTCA)?
A gated CT scan with intravenous iodinated contrast that images the coronary arteries directly. It shows the lumen, the degree of narrowing (stenosis), and the type and extent of plaque. NICE CG95 recommends it as the first-line investigation for stable chest pain of suspected cardiac origin.
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How is CTCA different from a coronary calcium score?
A calcium score is a non-contrast scan that only counts calcium (Agatston score) — it says nothing about the lumen or soft plaque. CTCA uses contrast and gating to show the arteries themselves. Calcium scoring is a screening test; CTCA is a diagnostic test for symptomatic patients.
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What is CT-FFR (HeartFlow)?
CT-FFR uses the CTCA dataset to compute the pressure drop across a stenosis — a functional assessment of whether the narrowing actually restricts flow. It reduces unnecessary invasive angiography and is a NICE-recommended add-on for intermediate stenoses.
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What is CaRi-Heart AI?
CaRi-Heart is an AI platform that measures the perivascular fat attenuation index (FAI) — a validated marker of coronary inflammation. It adds a future-event risk layer beyond stenosis and calcium, and is increasingly used in high-end private cardiology work-ups.
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How much radiation is involved?
A modern low-dose CTCA delivers approximately 2–5 mSv — roughly one to two years of natural background radiation. Older scanners deliver more; we route to scanners with the lowest-dose protocols.
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When should I skip a private CTCA and go to A&E?
If chest pain is severe, at rest, associated with sweating, breathlessness or radiation to the arm or jaw, or if symptoms are rapidly worsening on medical therapy, call 999 or go to A&E. CTCA is for stable, elective work-up — not acute coronary syndrome.
Sources
- NICE. Chest pain of recent onset: assessment and diagnosis (CG95).
- European Society of Cardiology. Guidelines on chronic coronary syndromes.
- British Society of Cardiovascular Imaging. Standards and guidance.
- American Heart Association. Cardiac CT position statements.
Last reviewed 2026-07-30 · Next review 2027-07-30 · Reviewed by Pulse Atlas Editorial Board, .
Related tests
Looking for a different test?
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CT coronary angiography
The formal CT angiogram — technical sibling of the CTCA.
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Coronary calcium score
Non-contrast Agatston calcium quantification for risk stratification.
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CT-FFR HeartFlow
Functional flow reserve derived from the CT dataset.
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In practice, in London
The London pathway for CT coronary artery scan ctca
With CT coronary artery scan ctca, the London question is usually about report turnaround and the radiologist reading it — not whether the scan is available. The wait for CT coronary artery scan ctca on the NHS depends heavily on where you live and how urgently the referral is graded. Central and West London private clinics can normally book within a week, with imaging or a procedure slot to follow shortly after. It’s worth being honest about the reason for going private: usually it’s time, not a fundamentally different test.
The mechanics are straightforward: a consultant appointment, any tests done at a nearby CQC-registered site, and a written report back within a few days. London’s density of private diagnostics — Marylebone, the City, Chelsea, Canary Wharf — means most patients can find something that fits around work without a cross-town trek. For CT coronary artery scan ctca specifically, the difference between a routine report and a sub-speciality read is where private care earns its keep.
There are a lot of consultants in London who can technically handle CT coronary artery scan ctca. Fewer who do it week in, week out for the exact question you’re bringing. We spend most of our time working out which is which — and being straight when a different test or a different specialist would serve you better. Everything runs to CQC, GMC and Royal College standards; the choice is about fit, not floor.