CT angiography is here--are we expected to see a change of angiography referral pattern?
A 52-year-old asymptomatic man, with cardiac risk factors of hypertension, Type II diabetes, hypertriglyceridemia, low HDL, obesity, and positive family history for early coronary artery disease (CAD), was referred to nuclear stress test. He exercised for 14 minutes, achieved his target heart rate, without any symptoms or ECG changes. Nuclear images were entirely normal. However, the patient was still concerned and anxious so he underwent CT angiography that revealed coronary narrowings. Next, he underwent coronary angiography with similar findings. The lesions were treated with stents. We present a case report to illustrate how newer technology such as CT angiography alters the way in which we diagnose CAD and decide on whether to pursue further invasive therapy.
Roguin
Ariel
A
Department of Medicine, Division of Cardiology, Johns Hopkins Medical Institutions, Baltimore, MD, USA. aroguin@technion.ac.il
Resar
Jon R
JR
D015906:Angioplasty, Balloon, Coronary; D019917:Blood Vessel Prosthesis Implantation; D020099:Coated Materials, Biocompatible / Q000627:therapeutic use; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000628:therapy; D006801:Humans; D007091:Image Processing, Computer-Assisted; D021621:Imaging, Three-Dimensional; D008297:Male; D008875:Middle Aged; D011857:Radiographic Image Interpretation, Computer-Assisted; D015607:Stents; D014057:Tomography, X-Ray Computed
D020099:Coated Materials, Biocompatible