title: Current Concepts in Cardiac CT Angiography for Patients With Acute Chest Pain.
abstract: This article presents specific examples of delayed diagnosis of acute coronary syndrome, acute aortic dissection, and pulmonary embolism resulting from evaluating patients with nonspecific acute chest pain who did not undergo immediate dedicated coronary CT angiography (CTA) or triple rule-out protocol (TRO). These concrete examples of delayed diagnosis may advance the concept of using cardiac CTA (i.e., dedicated coronary CTA versus TRO) to triage patients with nonspecific acute chest pain. This article also provides an overall understanding of how to choose the most appropriate examination based on the specific clinical situation in the emergency department (i.e., dedicated coronary CTA versus TRO versus dedicated pulmonary or aortic CTA), how to interpret the CTA results, and the pros and cons of biphasic versus triphasic administration of intravenous contrast material during TRO examination. A precise understanding of various cardiac CTA protocols will improve the diagnostic performance of radiologists while minimizing hazards related to radiation exposure and contrast use.
authors.affiliation: Department of Diagnostic Radiology, CHA Medical University Hospital, Seongnam, Korea.
authors.forename: Seung Min
authors.initials: SM
authors.lastname: Yoo
authors.forename: Ji Young
authors.initials: JY
authors.lastname: Rho
authors.forename: Hwa Yeon
authors.initials: HY
authors.lastname: Lee
authors.forename: In Sup
authors.initials: IS
authors.lastname: Song
authors.forename: Jae Youn
authors.initials: JY
authors.lastname: Moon
authors.forename: Charles S
authors.initials: CS
authors.lastname: White