title: Coronary computed tomography angiography for the assessment of chest pain: current status and future directions.
abstract: Chest pain is one of the most common presenting symptoms leading to presentation to medical clinics and Emergency Departments worldwide. Defining the nature and etiology of chest pain can pose a diagnostic dilemma for clinicians, despite the availability of several diagnostic algorithms and guidelines to assist them in evaluating these patients. Most investigations in patients with acute chest pain are initially performed to either exclude or diagnose and manage potentially life-threatening conditions such as acute coronary syndrome, pulmonary embolism and aortic dissection. In cases of stable chest pain syndromes, the focus shifts to determining the presence, extent and severity of coronary artery disease. In recent years, coronary computed tomography angiography (CCTA) is being increasingly used worldwide in the assessment of both stable and acute chest pain syndromes. This review evaluates the current evidence regarding the clinical utility of CCTA in the stable and acute chest pain settings and outlines the latest advances in CCTA techniques, including functional assessment of coronary stenoses, and their potential clinical application to improve patient care in a cost-effective manner.
authors.affiliation: Department of Medicine (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, 246 Clayton Road, Clayton, Melbourne, 3168, Australia. arthur.nasis@monashhealth.org.
authors.forename: Arthur
authors.initials: A
authors.lastname: Nasis
authors.affiliation: Department of Medicine (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, 246 Clayton Road, Clayton, Melbourne, 3168, Australia.
authors.forename: Ian T
authors.initials: IT
authors.lastname: Meredith
authors.affiliation: Department of Medicine (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, 246 Clayton Road, Clayton, Melbourne, 3168, Australia.
authors.forename: James D
authors.initials: JD
authors.lastname: Cameron
authors.affiliation: Department of Medicine (MMC), Monash Cardiovascular Research Centre, MonashHEART, Monash Health and Monash University, 246 Clayton Road, Clayton, Melbourne, 3168, Australia.
authors.forename: Sujith K
authors.initials: SK
authors.lastname: Seneviratne
mesh_terms: D000787:Angina Pectoris / Q000000981:diagnostic imaging* / Q000191:economics / Q000453:epidemiology; D017023:Coronary Angiography / Q000191:economics / Q000379:methods* / Q000639:trends; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000191:economics / Q000453:epidemiology; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D003362:Cost-Benefit Analysis; D005544:Forecasting; D017048:Health Care Costs; D006801:Humans; D061330:Multidetector Computed Tomography / Q000191:economics / Q000639:trends; D011237:Predictive Value of Tests; D011379:Prognosis; D015203:Reproducibility of Results; D012307:Risk Factors
keywords: Chest pain; Coronary artery disease; Coronary computed tomography angiography