Cardiac CT Angiogram patient information leaflet

This leaflet is intended for patients attending for a Cardiac CT Angiogram.

Introduction

• A cardiac CT angiogram will localise the blood vessels supplying blood to the heart and the anatomy of the heart itself.
• These images are enhanced by using an iodine-based contrast dye that highlights the blood vessels on the scan.
• The scan is performed in two parts. The first part is an unenhanced scan (no contrast injection) which looks for calcification in the blood vessels around the heart.
• Depending on what is identified on this scan, we will progress to the second part where you have an injection of dye to get a better picture of the blood flow in these vessels. As the contrast dye shows up white, the same as any calcification, we do the first scan without the injection.

How long will I be in the department?

You will be in the department for up to one hour.

What to do when you arrive

Please check-in at the CT Reception desk.

You may be asked to complete some forms prior to being called in for your scan.

Staff you are likely to meet

• Clinical Support Workers (CSW)
• Radiographers
• Cardiac Specialist Radiologist
• Cardiologist

Preparation for examination

• Avoid caffeine completely for a minimum of 8 hours before your scan. Examples include; coffee, tea, energy drinks, fizzy drinks, chocolate and certain cold & flu medications. If in doubt please check the label.
• Apart from the above you may eat and drink as normal before your scan.
• Please continue to take your routine medications, including beta blockers (such as Bisoprolol) even on the day of your scan.
• If you are taking tablets for erectile dysfunction- for example sildenafil (Viagra), tadalafil (Cialis) or vardenafil (Levitra)- you should stop taking these for three days before your scan appointment. Let the radiographer know if you routinely take these medications.
• Please don’t apply body lotions on the day of your scan e.g. body creams.
• Please fill in the attached questionnaires and bring them with you to your appointment.

Please contact the CT Reception in advance of your procedure/examination on 01223 217426 if you:

• Have additional requirements that may require a longer appointment,
• Require a specific appointment time due to taking time sensitive medication (e.g. insulin, medicines for Parkinson’s disease),
• Are claustrophobic,
• Are pregnant,
• Require hospital transport,
• Are unable to lie flat,
• Have mobility issues,
• Weigh 150 kg or more.

Risks

A specialist in radiology agrees that this is the best test to answer the clinical question that has been asked and that the benefit of the examination is greater than the risk. The CT scan involves a low dose of ionising radiation, equivalent to a few weeks or months of natural background radiation which we are all exposed to every day. Ionising radiation can cause cell damage that may turn cancerous however the risk of this happening from your examination is considered very low. The dose delivered will be kept as low as is practicable.

What will happen on the day of my examination?

• You will be asked to undress from the waist up and to wear a hospital gown (if you would like you can bring your own dressing gown to wear).
• Please don’t wear anything metallic around the chest area e.g. necklaces. If worn, a sports bra without any metal is preferable.
• A cannula (needle) will be inserted into your arm which will be used for the contrast dye injection.
• You will have your heart rate monitored via an (ECG) monitor. To do this you will have four small stickers placed on your chest. Hairy areas may need shaving. Whilst ECG tabs are being placed there will be another staff member acting as a chaperone as per the Hospital policy.
• Blood pressure will be checked before and after the scan. There may be two additional medications administered:
  • A beta blocker injection: this temporarily slows your heart rate down for 20-30 minutes allowing clearer images of the heart.
  • Glyceryl trinitrate (GTN) spray: this temporarily dilates the blood vessels for the scan. GTN can cause a short lasting headache but should wear off after 15-20 minutes. If you have been prescribed GTN spray please bring it with you.
• You will be asked to place your arms above your head for the duration of the scan (approximately five minutes).
• At this point the scan will start, you will be asked to hold your breath and be given the injection of contrast dye, after which it is common to feel a short-lived hot flush all over the body.
• Once adequate images have been taken you will be asked to wait for 15 minutes before your cannula is removed.

Accessibility requirements

If you require support for your appointment, e.g. if you find it hard to hear, see or be understood by others, please let the receptionist or healthcare professional know on arrival or contact us by email: cuh.accessibility@nhs.net or telephone: 01223 256998.

Pregnancy status

We have a legal responsibility to enquire if you are pregnant. Any patient aged between 12-55 years will be asked if there is a possibility they could be pregnant. This is important for us to know before you have your examination involving ionising radiation.

You can discuss this with a healthcare professional in private if you wish.

Medication

Bring all of your medicines (including inhalers, injections, creams, eye drops or patches) and a current repeat prescription from your GP.

Can I bring someone with me?

Those accompanying you may be required to stay out of the examination room during the procedure and remain in the waiting area.

Childcare whilst in department

Staff are unable to look after or supervise children whilst your procedure/examination is taking place. Please make alternative arrangements for the care of your children whilst you attend for your procedure/examination. If you attend an appointment with children with no one to look after them whilst you have your examination/procedure, then your appointment will unfortunately have to be cancelled and rescheduled.

Personal belongings

These can be brought into the scan room during your examination.

What happens after my examination?

• You may eat, drink and carry out activities as normal.
• You may drive home; we recommend allowing 30 minutes after your scan for medications to wear off. Do not drive if you still feel dizzy or light headed.
• If you have any questions about medications please contact your doctor in clinic who referred you for the scan.

Possible side effects and additional aftercare

• The medication used in your scan rarely causes side-affects.
• Safety checks are performed before and after your scan to ensure the risk of medication reactions are very low.
• The Radiographers undergo additional training to manage reactions to medication if this occurs.

It is unlikely however, should you feel unwell in any way or have any sign of an adverse reaction after your scans please contact your GP or local Emergency Department immediately.

How, when and by whom will my results be communicated?

• Imaging examinations are reported in order of clinical priority to ensure those with the highest urgency are reported first.
• Your referring team or clinician will be responsible for communicating reports back to you.
• Test results are made available via MyChart but there is 3-week delay from when an examination has been reported to when it is available on MyChart, in order to allow time for your clinical team to be able to see and action the results prior to them being released to the individual patient.

Are there any alternative tests?

An invasive coronary angiogram is an alternative test if you are unable to have a CT scan.

Contacts/Further information

CT Department Reception: 01223 217426

Facilities available

Accessible toilets

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Directions to the department

The CT department is located on level 2 (ground floor) in the outpatient part of the hospital – near oncology.

The full address is:

CT Department

Addenbrooke’s Hospital

Cambridge University Hospitals NHS Foundation Trust

Hills Road

Cambridge

CB2 0QQ

Question, concern or complaint?

Firstly, speak to your nurse, doctor or other staff member as soon as you can so they can do their best to put things right straightaway.

If you don’t feel able to speak directly to the people caring for you, contact the patient advice and liaison service (PALS). Please call 01223 216756 9am to 4pm Monday to Friday, via email at cuh.pals@nhs.net, or via a form available via link on the CUH PALS webpage.

PALS is open every weekday, and you can leave a message in the evenings and weekends.

MyChart

We would encourage you to sign up for MyChart. This is the electronic patient portal at Cambridge University Hospitals that enables patients to securely access parts of their health record held within the hospital’s electronic patient record system (Epic). It is available via your home computer or mobile device

More information is available on our website: My Chart