Cardiac CT in the emergency department: Convincing evidence, but cautious implementation

In clinical practice, assessment of chest pain patients presenting to the emergency department is difficult and the work-up can be lengthy and costly. There is growing evidence supporting the use of coronary computed tomography angiography (CTA) in early assessment of patients presenting with acute...

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Bibliographic Details
Published in:Journal of nuclear cardiology 2011-04, Vol.18 (2), p.331-341
Main Authors: Cury, Ricardo C., Feuchtner, Gudrun, Mascioli, Carol, Fialkow, Jonathon, Andrulonis, Paul, Villanueva, Tomas, Pena, Constantino S., Janowitz, Warren R., Katzen, Barry T., Ziffer, Jack A.
Format: Article
Language:English
Subjects:
Acute Coronary Syndrome - diagnostic imaging
Cardiology
Coronary Angiography - methods
Electrocardiography
Emergency Service, Hospital
Humans
Imaging
Medicine
Medicine & Public Health
Nuclear Medicine
Radiology
Review Article
Tomography, X-Ray Computed - methods
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Summary:In clinical practice, assessment of chest pain patients presenting to the emergency department is difficult and the work-up can be lengthy and costly. There is growing evidence supporting the use of coronary computed tomography angiography (CTA) in early assessment of patients presenting with acute chest pain to the emergency department. CTA appears to be a faster and more accurate way to diagnosis or rule out coronary stenosis, leading to reduced hospital admissions, decreased time in the ED and lower costs. The focus of this article is to review the current literature of the use of Coronary CTA and “triple rule out” protocols in the emergency department setting and to provide a chest pain algorithm, showing how Coronary CTA can be implemented effectively in clinical practice. Potential pitfalls and requirements for implementation will also be discussed.
ISSN:1071-3581
1532-6551
DOI:10.1007/s12350-011-9356-1