Be still, my beating heart! The challenge of relaxing enough for a cardiac CT scan

I just had a cardiac CT scan to check for clogged heart arteries, because my blood is rotten with lipids despite being quite fit, because genetics apparently — a fairly severe case of familial hypercholesterolemia.

But arteries don’t get icky automatically: it takes a perfect storm of cholesterol + other factors. So maybe my heart is fine, and maybe it’s not. I’ve never had a spot of angina, so I’m somewhat optimistic, I guess? I’ll get the results in a few days from my cardiologist. Much suspense. Dun-dun-DUN.

To take a good heart picture, you’ve got to slow the heart down. If it’s too fast, it’s as blurry as a Bigfoot photo. If you’re under an HR of 65, it’s easy, a fast scan. If you’re over 65, not so much: you can get stuck in that room a long time, my technician explained… hours of fun as they try to basically calm you down and tinker with your physiology until they can get a good picture.

I bet that’s really fun. “Calm down … faster.”

Bedside manner with an objectively measurable purpose

To improve the odds of getting a good image, you prep for the test: take a beta blocker, drink a bunch of water, avoid coffee. I got diarrhea from the beta blocker, whee, and a good caffeine withdrawal headache, so I wasn’t exactly in my best mood. But my heart rate was 50, and so my technician was delighted.

“Oh, you’re going to be a piece of cake,” she says.

That’s me. Cake. Calm cake.

I believe in being super nice to healthcare professionals, and so I complimented my technician on her excellent communication and educational style, and she laughed and said (and this was quite interesting and the reason I decided to tell this story):

“Oh, thank you, but it’s more than just a nicety, it’s really part of the job here... because guess what happens if you don’t fully inform people? If they are wondering what the hell is going on, their heart rate goes up! And then you can’t take a picture of their heart. So good bedside manner actually has an important, specific, objectively measurable purpose in this room.”

Cool. Actually quite interesting.

And then she stabbed me without warning

She stuck a huge needle into my arm for the contrast agent, which delivers a groinal flush that really and truly makes you feel like you’re pissing yourself. Fun! But that needle! Shit! It was a 🤬 harpoon!

“That was an unusually painful needle,” says the cake.

“Yeah, it’s a monster. That’s something I try not to warn you about in advance. I actually try to hide it.”

“Because it would have gotten my heart rate up?”

“Bingo!”

2025 UPDATE: The results were almost eerily perfect, attributable to some protective genes and/or being quite fit. As of 2025, I’m in remarkably good shape, with seemingly zero consequences from my years of disturbingly high LDL … and now the LDL is also entirely relieved, expensively but effectively controlled with Repatha, an alternative to statins. Read more.