Cardiac CT Scan

From 1 July 2011, the federal government/Medicare will reimburse for Computed Tomography of the Coronary Arteries under certain conditions: If the procedure is performed on a minimum of a 64 slice (or equivalent) scanner, where the request is made by a specialist or consultant physician, and: a) the patient has stable symptoms consistent with coronary ischaemia, is at low to intermediate risk of coronary artery disease and would have been considered for coronary angiography; or b) the patient requires exclusion of coronary artery anomaly or fistula; or c) the patient will be undergoing non-coronary cardiac surgery (for example, aortic valve replacement surgery). These above items can only be claimed if the procedure and report were performed by a specialist or consultant physician recognised by the Conjoint Committee for the Recognition of Training in CT Coronary Angiography. Drs. Szto and Watson as both qualified to provide for this Medicare service.

This is where you can get information on this exciting and innovative technology.

In the following series of videos, you can be acquainted with the CT scanning technology, and understand how it is applied to the heart to obtain information about the state of your coronary arteries, even before you become symptomatic with chest pains, heart attacks etc.

Calcium Score

A calcium score is a numerical value that quantifies the amount of calcium found along your coronary artery. Calcium deposited on the rim of the coronary artery is solely the result of coronary atherosclerosis, and NOT from ingesting calcium. A calcium score of 0 means there is no coronary artery disease. A high calcium score (more than 400) is very concerning for the high likelihood of established severe coronary artery disease, even if you are asymptomatic. Sometimes, a calcium score may be the only CT portion of the test required, especially among younger individuals, or for individuals who are planning to undergo very frequent (annual) testing, in order to reduce the amount of radiation exposure.

See a movie of a Rotating coronary tree and a Rotating heart. Download a CT Scan Request Slip here. Download a CT Scan Information Sheet here. This test is one of the single most important advance in the development of non-invasive heart and coronary artery imaging. Multi-slice CT (MSCT) coronary angiogram allows doctors to determine if an individual has any coronary artery narrowing even before symptoms develop. Through an intravenous drip in the elbow, contrast dye is injected, and the person is asked to hold his/her breath for about 10 -15 seconds, and lie very still. After the CT scanner has obtained the X-ray images, the person is allowed to go home, a procedure which takes approximately 60 minutes. MSCT allows us to “look” into and through the heart and any structures that are within the heart. This include the sac around the heart (pericardium). Next, coronary arteries, their walls and contents (cholesterol plaques) are prominently and accurately quantified and measured. Hardened cholesterol plaques develop calcium, which can be quantified into a format (Calcium Score) to predict future cardiovascular events like heart attacks. Individuals at high risk for a heart attack, with risk factors such as diabetes, high blood pressure, high cholesterol, smoking, and family history of premature heart disease, will benefit from knowing if they harbour any (asymptomatic) coronary artery blockages.

If you believe you will benefit from having a CT coronary angiogram to check the status of your coronary arteries, you may obtain a request slip/form (see top) and discuss with your doctor about having the test performed.

Dr. Szto and Multislice Cardiac CT Scan

Dr. Szto underwent formal training in the performance and interpretation of MSCT scans, having trained in Los Angeles (Dr.Matthew Budoff), and subsequently supervise the performance of over 2000 scans since February 2007. He is a member of the Society of Cardiac Computed Tomography (SCCT). This test attracts a Medicare rebate, you will be out of pocket ~$185 (as of 2011) for the procedure. For a calcium score procedure (a subset of the CT scan), the cost is ~$250. CT scanning is performed in collaboration with MIA Radiology at Peninsula Private Hospital. Reports are produced by Dr. Szto and/or Dr. Andrew Watson or an accredited MIA radiologist.