title: Cardiac computed tomography in patients with acute chest pain.
abstract: The efficient and reliable evaluation of patients with acute chest pain is one of the most challenging tasks in the emergency department. Coronary computed tomography (CT) angiography may play a major role, since it permits ruling out coronary artery disease with high accuracy if performed with expertise in properly selected and prepared patients. Several randomized trials have established early cardiac CT as a viable safe and potentially more efficient alternative to functional testing in the evaluation of acute chest pain. Ongoing investigations explore whether advanced anatomic and functional assessments such as high-risk coronary plaque, resting myocardial perfusion, and left ventricular function, or the simulation of the fractional coronary flow reserve will add information to the anatomic assessment for stenosis, which would allow expanding the benefits of cardiac CT from triage to treatment decisions. Especially, the combination of high-sensitive troponins and coronary computed tomography angiography may play a valuable role in future strategies for the management of patients presenting with acute chest pain.
authors: Erasmus MC, Department of Cardiology, Room Hs207, PO Box 2040, Rotterdam 3000 CA, The Netherlands Erasmus MC, Department Radiology, Rotterdam 3000 CA, The Netherlands koennieman@hotmail.com.
authors: Koen
authors: K
authors: Nieman
authors: Cardiac MR PET CT Program, Massachusetts General Hospital and Harvard Medical School, 165 Cambridge Street, Suite 400, Boston, MA 02114, USA.
authors: Udo
authors: U
authors: Hoffmann
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging; D059787:Acute Pain / Q000000981:diagnostic imaging; D002637:Chest Pain / Q000000981:diagnostic imaging* / Q000209:etiology; D017023:Coronary Angiography / Q000379:methods; D003937:Diagnosis, Differential; D004630:Emergencies; D004636:Emergency Service, Hospital; D005544:Forecasting; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging; D009204:Myocardial Revascularization / Q000379:methods; D064887:Observational Studies as Topic; D058226:Plaque, Atherosclerotic / Q000000981:diagnostic imaging; D011379:Prognosis; D016032:Randomized Controlled Trials as Topic; D014057:Tomography, X-Ray Computed / Q000379:methods; D014218:Triage / Q000379:methods; D014336:Troponin / Q000378:metabolism
chemical_list: D014336:Troponin
keywords: Acute chest pain; Acute coronary syndrome; Computed tomography; Diagnostic triage; Myocardial infarction; Review