title: Coronary computed tomography angiography for the evaluation of patients with acute chest pain.
abstract: Acute chest pain is a common presenting complaint of patients attending emergency room departments. Despite this, it can often be challenging to completely exclude a diagnosis of acute coronary syndrome following an initial standard clinical and biochemical evaluation. As a result of this, patients are often admitted to hospital until the treating clinician is satisfied that this diagnosis can be excluded. This process imparts a significant health economic burden by not only increasing hospital bed occupancy rates but also by the unnecessary layering of diagnostic investigations. With the rapid advances in coronary computed tomography angiography (CTA), there has been considerable interest in whether coronary CTA may be a viable alternative to this current standard care. We review the current literature and supporting evidence for utilising coronary CTA in the evaluation of patients presenting with acute chest pain in terms of its diagnostic accuracy, safety, cost-effectiveness and prognostic implications.
authors.affiliation: Department of Cardiac Computed Tomography, St Thomas' Hospital, London, UK. dr.r.rajani@gmail.com
authors.forename: R
authors.initials: R
authors.lastname: Rajani
authors.forename: R L
authors.initials: RL
authors.lastname: Brum
authors.forename: R
authors.initials: R
authors.lastname: Preston
authors.forename: G
authors.initials: G
authors.lastname: Carr-White
authors.forename: D S
authors.initials: DS
authors.lastname: Berman
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D059787:Acute Pain; D000328:Adult; D002637:Chest Pain / Q000000981:diagnostic imaging / Q000191:economics / Q000209:etiology*; D017023:Coronary Angiography / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000191:economics; D003362:Cost-Benefit Analysis; D004636:Emergency Service, Hospital / Q000191:economics / Q000706:statistics & numerical data; D005260:Female; D005544:Forecasting; D006801:Humans; D033162:Incidental Findings; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011829:Radiation Dosage; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed / Q000009:adverse effects / Q000191:economics / Q000379:methods*