Saturday, August 11, 2012

Coronary CT Angioghaphy can be a Better Idea to Evaluate Chest Pain of Non-Cardiac Origin

Traditionally, acute heart attack presenting with the symptoms like chest pain is evaluated by means of ECG (Electrocardiography) and cardiac enzyme assays like cardiac troponin test (A Blood test).

Sometimes, those tests may give equivocal results necessitating further hospital stay for observation and repeat tests; and additional procedures.


Incorporating coronary CT angiography (CCTA) into the initial evaluation of low-risk patients coming to hospital emergency departments with chest pain appears to reduce the time patients spend in the hospital without incurring additional costs or exposing patients to significant risks, concludes one study from Massachusetts General Hospital (MGH).

They found that the use of CCTA in emergency department evaluation of acute chest pain very effectively identified which patients did or did not have coronary artery obstruction, allowing clinicians to focus the use of resources on patients with heart disease.

CCTA combines advanced CT scanning with the use of intravenous contrast material to produce detailed images of blood vessels supplying the heart without the need for cardiac catheterization.

The investigators found that participants in the CCTA group had significant reductions in the amount of time from ED arrival until discharge either from the ED or after a hospital stay, with half of the CCTA group being discharged within 8.6 hours but only 10 percent of the control group being released so quickly.

The amount of time until a diagnosis of heart disease was either ruled out or confirmed was also shorter for the CCTA group than for the controls, and more patients receiving CCTA were discharged directly from the ED rather than being admitted to an observation unit.

The percentage of patients actually diagnosed with heart disease was similar in both groups at around 8 percent, and there were no missed diagnoses in either group.

The issue of radiation dose can be addressed by more improved technique, small dose CT.

The original article published in Massachusetts release can be accessed here


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