CT Coronary Angiogram

Note: Specialist Referral required for Medicare Bulk Billing / Rebate

A CT Coronary Angiogram is an invasive test analyses the blood vessels. It involves a contrast injection through a vein in the arm.

Indications for a CT Coronary Angiogram:

  1. Consistent Symptoms Suggesting Heart Problems: If you are experiencing stable symptoms such as chest pain that may suggest a lack of blood flow to your heart (coronary ischemia), and you are assessed to be at low to intermediate risk of coronary artery disease, your doctor may recommend this test. This test is particularly useful for individuals experiencing chest pain that needs further investigation.

  2. Suspected Anomalies in Coronary Arteries: If your doctor suspects that you may have an abnormality in your coronary arteries, like an unusual connection (fistula) or structure, a CT coronary angiogram can help to confirm or rule out this condition.

  3. Upcoming Non-Coronary Cardiac Surgery: If you are preparing for a non-coronary cardiac surgery, like valve surgery, your doctor might request this test. It allows them to get a detailed view of your heart and its arteries before the procedure, which aids in surgical planning and risk assessment.

 

A CT Coronary Angiogram (CTCA) is a non-invasive imaging test that provides detailed pictures of the coronary arteries, which supply blood to the heart. It is a safer alternative to conventional coronary angiograms that involve invasive procedures and needle insertion in the groin area. During a CTCA, a special CT scanner takes multiple X-ray images of the heart from different angles. These images are then used by a computer to create a 3D view of the coronary arteries. By looking at these images, doctors can identify any blockages, narrowings, or plaques that may affect blood flow to the heart. The test involves receiving a contrast dye through a vein in your arm, which helps make the images clearer. It does not require any tubes or wires to be inserted inside your body.

Risks Associated with the Test:

  • Radiation: X-rays are used during the scan, but our facility utilises a low-dose CT scanner to minimize radiation exposure. The typical radiation dose is around 0.5mSv - 2mSv, which is significantly lower than some other CT scanners and perfectly safe.
  • Contrast Reaction: Allergic reactions to the contrast dye used during the test are very rare. In rare cases, patients may experience an itchy rash or a temporary worsening of asthma symptoms. Patients with kidney failure need cautious administration of contrast due to its potential temporary impact on kidney function. Severe life-threatening reactions are extremely rare, occurring in approximately 1 in 250,000 cases.
  • Contrast Leakage: On rare occasions, the contrast may leak into the tissues under the skin instead of entering the vein. This can cause bruising, swelling, and mild discomfort. We take precautions to minimise the risk of contrast leakage and closely monitor the injection process.

What to Expect:

  1. Gown and Monitoring: You will change into a gown and have your blood pressure and heart rate monitored. A radiologist or cardiologist will assess you, and additional medication may be administered if necessary.
  2. Cannula and ECG Leads: A plastic needle (cannula) will be inserted into a vein near your elbow, and ECG leads will be placed on your chest.
  3. Nitrolingual Spray: You may receive Nitrolingual spray under your tongue before the scan to help relax your coronary arteries and obtain clearer images. This may cause a mild headache.
  4. Contrast Injection: During the scan, you may feel a warm sensation and experience a metallic taste in your mouth when the contrast is injected. This is normal.
  5. Breath Holding and Positioning: For some scans, you will be asked to hold your breath for up to 15 seconds and lie flat for about 5-10 minutes.
  6. Time and Post-Procedure Care: The scan itself is fast, but the entire process may take up to 2 hours. After the examination, you may need a short period of monitoring. Beta-blockers used during the test may cause drowsiness, so it is advisable to arrange transportation home.

Results:

Any urgent or unexpected findings will be promptly communicated to your referring doctor. Routine test results typically take 2-3 days. If you have any questions or concerns about the test, please discuss them with your referring doctor.

(This test will take up to 2-3 hours)

Please Follow These Instructions:

Pre-Medication Regimen:

    • If your doctor prescribed it, take Metoprolol (50-100 mg) the night before and 8 am on the morning of your CT scan. This helps keep your heart rate around 60 beats per minute or lower. OR
    • If you are already taking beta blockers or calcium channel blockers to maintain a heart rate of 60 beats per minute or lower, continue taking them as usual.

Other Preparation:

    • Take all your regular morning medications, except for metformin.
    • Try to fast for at least 4 hours before your CT scan, if possible.
    • Avoid caffeine from any sources, such as coffee, tea, and energy drinks, for 24 hours before your CT scan.
    • Do not take Cialis, Viagra, Levitra, or similar medications for at least 36 hours before your CT scan.

Please follow these instructions carefully to ensure accurate and reliable results from your Coronary CT Scan. If you have any questions or concerns about the preparation, don't hesitate to reach out to your doctor or the medical staff conducting the test. They will be happy to assist you.