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Streamlined Cardiac Care

Streamlined Cardiac CT

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A comprehensive approach to cardiac care

At Advara HeartCare, it is our purpose to improve Australia’s Heart Health. To do this, we are committed to delivering integrated cardiac care that works for both patients and doctors. Our streamlined cardiac CT pathways combine expert Cardiologist opinions with the diagnostic power of cardiac CT, allowing your patients rapid access to world-class cardiovascular care.

Helping GPs reduce their patients’ cardiac investigation latency

With our streamlined CT pathways, clinically appropriate patients have rapid access to cardiologist review, and if appropriate are referred for a CT scan directly. This reduces delay in their diagnostic process and enables specialist review and management, resulting in continuity of care and world-class patient experience.

Helping GPs reduce their patients’ cardiac investigation latency

With our streamlined CT pathways, clinically appropriate patients have rapid access to cardiologist review, and if appropriate are referred for a CT scan directly. This reduces delay in their diagnostic process and enables specialist review and management, resulting in continuity of care and world-class patient experience.

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Indications to refer patients for Cardiac CT

Streamlined CT Coronary Angiogram for Symptomatic patients

For symptomatic patients, CTCA includes all the information of a calcium score and identifies the degree of coronary stenoses caused by calcified or non-calcified plaque, which are the known cause of most myocardial infarctions.

In patients with stable symptoms suggestive of CAD (such as stable chest pain, SOB, fatigue), but without previously documented CAD, CTCA is often the preferred investigation in the first instance.4Fyyaz, S., Papachristidis, A., Byrne, J. and Alfakih, K., 2018. Opinions on the expanding role of CTCA in patients with stable chest pain and beyond: a UK survey. British Journal of Cardiology, 25, pp.107-109

*Medicare rebates are available for this test

Calcium Score Scan for Asymptomatic Patients

For asymptomatic patients, calcium scores—in addition to clinical risk assessments—can be useful to enhance precision in cardiac event risk prediction and to provide guidance for pharmacological treatment decisions.3Australian guideline and calculator for assessing and managing cardiovascular disease risk

This scan shows a score that represents the amount of calcified plaque built up in the coronary arteries and can help reclassify a patient’s risk either up or down, as referenced in the new Australian Cardiovascular Disease Risk Calculator, leading to better cardiac management. Any non-zero score indicates the presence of calcified atherosclerosis.

Calcium scores are expressed in absolute values alongside a percentile, which considers factors such as sex, age, and ethnicity. The Cardiac Society of Australia and New Zealand (CSANZ) classifies calcium scores into distinct categories associated with a specific level of cardiovascular risk.

Risk Classification – CAC Score7Coronary artery calcium in primary prevention – Australian Journal of General Practice – Volume 49, Issue 8, August 2020

Calcium ScoreInterpretationRisk of myocardial infraction/stroke at 10 years
0Very low risk<1%
1-100 Low risk <10%
101-400 Moderate risk 10-20%
101-400 >75th percentile Moderately high risk 15-20%
>400 High risk >20%
*Adapted from the Australian Journal of General Practice (RACGP), Aug 2020

*No Medicare Benefits Schedule items exist for calcium scoring

Refer a patient for Cardiac CT (CAC or CTCA)

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South Australia

SA Cardiology Referral Form
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Victoria

VIC Cardiology Referral Form
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Western Australia

WA Cardiology Referral Form
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Queensland

QLD Cardiology Referral Form
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New South Wales

NSW Cardiology Referral Form

The role of Cardiac CT in early detection of CAD

CTCA scans detect the presence of luminal stenoses in the coronary arteries and is indicated generally only for patients experiencing potential symptoms of coronary artery disease, such as chest pain. A calcium score on the other hand is used to detect the presence or absence of calcified atheromatous disease and is indicated generally in risk assessment and management decisions around lipid lowering therapy.

The role of Cardiac CT in early detection of CAD

CTCA scans detect the presence of luminal stenoses in the coronary arteries and is indicated generally only for patients experiencing potential symptoms of coronary artery disease, such as chest pain. A calcium score on the other hand is used to detect the presence or absence of calcified atheromatous disease and is indicated generally in risk assessment and management decisions around lipid lowering therapy.

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Cardiac CT: What Does it Show?

Calcium Score (CAC) 
Asymptomatic Patients

This scan shows a score that represents the amount of calcium buildup in the coronary arteries. Any non-zero score indicates the presence of atherosclerosis. 

CAC Calcium Score Scans – example

CT Coronary Angiogram (CTCA) 
Symptomatic Patients 

CTCA shows the calcium score, and additionally the presence or absence of stenosis in the coronary arteries – whether they are calcified or not. 

CTCA Scans – example

This test is available at the following locations:

Melbourne Victoria

Doncaster East, VIC

Australian sunset

Milton, QLD

Murdoch (1)

Murdoch, WA

adelaide_city (1)

St Andrew's Hospital, SA

NSW skyline

Burwood, NSW

FAQs

Which patients should be considered for a streamlined CTCA instead of a Calcium Score?

Typically

  • Patients with stable symptoms suggestive of CAD (stable chest pain, SOB, fatigue), but without previously documented CAD.
  • Patients with a history of previous tests, such as stress echo, or those who had a calcium score test=0, but have subsequently developed symptoms of chest pain.1Early outcomes following integration of computed tomography (CT) coronary angiography service in an established cardiology practice in disease management David Playford a b, Nisha Schwarz a, Anna E. Williamson a, MyNgan Duong a, Amied Shadmaan c, Daneh Turner c, Stuart Behncken a, Tom Phillips a, Leighton Kearney.

Which patients should have a streamlined CTCA instead of an Exercise Stress Echo?

Current international guidelines designate CTCA a first-line test for patients with low to intermediate risk of CAD without known history of CAD.8European Heart Journal: Great Debate: Computed tomography coronary angiography should be the initial diagnostic test in suspected angina. Colin Berry, Christopher M Kramer, Vijay Kunadian, Toral R Patel, Todd Villines, Raymond Y Kwong, and Daniell Edward Raharjo Eur Heart J. 2023 Jul 7; 44(26): 2366–2375.

Exercise Stress Echo is recommended for symptomatic patients with intermediate–to –high risk of CAD and/or previous history of CAD.6Stress echocardiography in coronary artery disease: a practical guideline from the British Society of Echocardiography. Richard P Steeds,1,* Richard Wheeler,2,* Sanjeev Bhattacharyya,3 Joseph Reiken,4 Petros Nihoyannopoulos,5,* Roxy Senior,6,* Mark J Monaghan,4,* and Vishal Sharma7 

What is the Radiation Dose of a CTCA?

The type of examination involved determines each dose. So too do other factors such as the specific type of equipment used, the patient’s age, gender, body size and anatomy.
Our trained medical staff consider all these factors. They only scan the part(s) of the body required and aim to keep the dose as low as possible while still achieving effective results.

Are Medicare rebates available for Streamlined CTCA?

Medicare rebates are available for CTCA provided the following conditions are met:

  • (a) the request is made by a specialist or consultant physician; and
  • (b) the patient has stable or acute symptoms consistent with coronary ischaemia; and
  • (c) the patient is at low to intermediate risk of an acute coronary event, including having no significant cardiac biomarker elevation and no electrocardiogram changes indicating acute ischaemia (R).

Visit the MBS website for detailed information.

Where is Streamlined CTCA offered?

Currently, our streamlined CTCA service is offered in 4 major metro areas in Australia

  • QLD: Milton, Sunshine Coast
  • SA: St Andrew’s Hospital
  • VIC: Doncaster East
  • WA: Murdoch
  • NSW: Burwood

How quickly do I receive results?

Once a CTCA scan is performed, results and any cardiac findings are reported back to your practice within 2 business days*

* 2 business days is the average time it takes for results to be reported back to referring doctors. Final reporting times may vary on each separate case based on each patient and location. 

 

What happens after the test?—how are results managed?

If the patient tests positive for CAD, results are discussed directly with the patient and the referring doctor–often immediately post-scan. Our team will work with you to determine the best treatment plan for the individual.