title: Cardiac CT in the assessment of acute chest pain in the emergency department.
abstract: OBJECTIVE
  The purpose of this article is to describe the current role of ECG-synchronized CT in the evaluation of patients with acute chest pain (triple rule-out) in the emergency department. We discuss clinical contexts of the chest pain algorithm, technical improvements that have enabled CT to attain its current role for this application, scan protocols and radiation considerations, the evidence base regarding diagnostic and prognostic performance, and initial data on the cost-effectiveness of this promising emerging test.
  
  
  CONCLUSIONS
  Currently available evidence suggests that CT-based approaches with modern scan technology are safe, accurate, and potentially cost-saving, although large-scale clinical trials are needed to ascertain the precise role of CT in the evaluation of acute chest pain.
authors.affiliation: Department of Radiology and Radiological Science, Medical University of South Carolina, Ashley River Tower, MSC 226, 25 Courtenay Dr., Charleston, SC 29425, USA.
authors.forename: Gorka
authors.initials: G
authors.lastname: Bastarrika
authors.forename: Christian
authors.initials: C
authors.lastname: Thilo
authors.forename: Gary F
authors.initials: GF
authors.lastname: Headden
authors.forename: Peter L
authors.initials: PL
authors.lastname: Zwerner
authors.forename: Philip
authors.initials: P
authors.lastname: Costello
authors.forename: U Joseph
authors.initials: UJ
authors.lastname: Schoepf
mesh_terms: D000328:Adult; D000792:Angiography / Q000379:methods; D002637:Chest Pain / Q000000981:diagnostic imaging*; D003327:Coronary Disease / Q000175:diagnosis; D003362:Cost-Benefit Analysis; D003937:Diagnosis, Differential; D004562:Electrocardiography / Q000191:economics / Q000379:methods*; D004632:Emergency Medical Services / Q000191:economics / Q000379:methods*; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011655:Pulmonary Embolism / Q000175:diagnosis; D019057:Quality-Adjusted Life Years; D011829:Radiation Dosage; D011856:Radiographic Image Enhancement / Q000379:methods; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed / Q000191:economics / Q000379:methods*