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Cardiac CT, Coronary CTA, Coronary Artery Calcium Score Requisition ORDERING PHYSICIAN Name: Signature: Copy to: Date (dd/mm/by): Department of Diagnostic Imaging TEL 613 9697400 x2860 (BGH) FAX completed
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How to Fill Out Cardiac CT Coronary CTA:

01
Before filling out the cardiac CT coronary CTA form, gather all the necessary patient information such as name, date of birth, and medical history.
02
Ensure that the form includes sections for relevant patient details, such as contact information and relevant medical conditions.
03
Provide space to document any allergies or contraindications to contrast agents used during the procedure.
04
Include sections for the ordering physician's information, such as name, contact details, and any specific instructions or concerns.
05
Make sure there is a clear section to document the reason for the cardiac CT coronary CTA request, including any specific symptoms or medical indications.
06
Ensure that the form allows for the selection of the appropriate imaging protocol, such as calcium scoring or full coronary angiography.
07
Provide areas to document any premedications given to the patient prior to the procedure, including anti-anxiety medications or beta blockers.
08
Include sections to document relevant laboratory results, such as renal function tests or any recent cardiac enzyme measurements.
09
Ensure that the form has space to record the date and time of the scheduled procedure, along with any necessary patient preparation instructions.
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Lastly, make sure the form includes a space for the radiologist's interpretation and any additional comments or recommendations.

Who Needs Cardiac CT Coronary CTA:

01
Individuals with suspected coronary artery disease (CAD), especially those who present with chest pain or other cardiac symptoms.
02
Patients with a history of CAD, previous heart attacks, or other cardiovascular conditions who require ongoing monitoring or assessment of their coronary arteries.
03
Individuals with risk factors for CAD, such as hypertension, diabetes, or high cholesterol levels, who may benefit from early detection and preventive measures.
04
Patients who have undergone other cardiac tests or imaging studies that suggest the need for further evaluation of their coronary arteries.
05
Individuals with known or suspected congenital heart diseases or structural abnormalities that may affect the coronary arteries.
06
Patients preparing for a cardiac intervention or surgical procedure, such as coronary artery bypass grafting or valve replacement, where detailed knowledge of the coronary anatomy is crucial.
07
Individuals who need follow-up imaging after a previous cardiac CT coronary CTA or other cardiac interventions to assess the efficacy of treatment or to monitor disease progression.
08
Patients participating in research studies or clinical trials that require non-invasive imaging of the coronary arteries.
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Individuals seeking a comprehensive assessment of their cardiovascular health, especially if other diagnostic tests have not yielded conclusive results.
10
Physicians may also request cardiac CT coronary CTA in specific situations based on their clinical judgment and the patient's unique circumstances, even if they don't fit into the typical categories mentioned above.
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Cardiac CT Coronary CTA is a type of imaging test that uses x-rays to create detailed pictures of the heart and its blood vessels.
Cardiac CT Coronary CTA may be required to be filed by healthcare providers or medical facilities providing cardiac imaging services.
To fill out Cardiac CT Coronary CTA, a qualified healthcare professional should follow the specific guidelines and requirements set forth by the regulatory bodies.
The purpose of Cardiac CT Coronary CTA is to help diagnose heart conditions, assess the severity of coronary artery disease, and evaluate the overall health of the heart.
The information reported on Cardiac CT Coronary CTA may include patient demographics, medical history, imaging findings, and any relevant clinical data.
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