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Cardiovascular Conditions

Aortic Surgery

Full Critical Illness Benefit Criteria

Undergoing aortic surgery to repair or correct one or more of the following:

  • An aortic aneurysm
  • An obstruction of the aorta
  • A coarctation of the aorta
  • A traumatic rupture of the aorta

Cardiomyopathy

Full Critical Illness Benefit Criteria

An unequivocal diagnosis by an appropriate specialist of impaired ventricular function of variable aetiology, resulting in permanent and irreversible physical impairments of at least Class 3 of the New York Heart Association classification of cardiac impairment.

Diagnosis Benefit Criteria

An unequivocal diagnosis by an appropriate specialist of cardiomyopathy.

Coronary Artery Surgery

Full Critical Illness Benefit Criteria

The 90-day stand-down applies to this condition.

Undergoing a coronary artery bypass grafting to correct or treat coronary artery disease.

Heart Attack

Full Critical Illness Benefit Criteria

The 90-day stand-down applies to this condition.

An unequivocal diagnosis by a cardiologist of a heart attack (myocardial infarction) where part of the heart muscle has died because of a lack of blood supply to the heart. This must be evidenced by a rise or fall of cardiac biomarkers, such as troponins, with at least one value above the upper reference range of laboratory normal (99th percentile), and at least one of the following:

  • New cardiac signs and symptoms consistent with a heart attack
  • Electrocardiogram (ECG) tests that show new changes associated with a heart attack
  • Imaging evidence of new loss of viable myocardium or new regional wall motion abnormality consistent with a heart attack

If the above tests are inconclusive, outdated because of technical advances, or they didn’t take place, we’ll consider other appropriate and medically recognised tests that diagnose a heart attack of the same degree of severity as outlined above.

This definition doesn’t cover:

  • Other acute coronary syndromes
  • Elevation of troponins in the absence of overt ischaemic disease

Heart Valve Replacement

Full Critical Illness Benefit Criteria

Undergoing surgery to replace or repair cardiac valves because of heart valve defects or abnormalities.

We exclude repair solely by intra-arterial/intra-vascular procedures or other non-surgical techniques.

Open Heart Surgery

Full Critical Illness Benefit Criteria

Undergoing open heart surgery to treat either:

  • A cardiac defect
  • Cardiac aneurysm
  • Benign cardiac tumour

We exclude treatment by catheter surgery, percutaneous devices, minimally invasive ‘keyhole’ or similar techniques.

Out-of-Hospital Cardiac Arrest

Full Critical Illness Benefit Criteria

A cardiac arrest that occurred out of hospital where all the following apply:

  • The cardiac arrest wasn’t associated with any medical procedure
  • An electrocardiogram documented the cardiac arrest
  • The cardiac arrest was caused by cardiac asystole, ventricular fibrillation, or ventricular tachycardia

Primary Pulmonary Hypertension

Full Critical Illness Benefit Criteria

An unequivocal diagnosis by an appropriate specialist of primary idiopathic pulmonary hypertension associated with right ventricular enlargement established by cardiac catheterisation.

Triple Vessel Angioplasty

Full Critical Illness Benefit Criteria

The 90-day stand-down applies to this condition.

Undergoing coronary artery angioplasty to correct a narrowing or blockage of three or more coronary arteries within a procedure period of 60 days.

The triple vessel angioplasty must be necessary because of angiographic evidence that indicates an obstruction of three or more coronary arteries.