Cardiac CT in the emergency department: Convincing evidence, but cautious implementation

被引:12
作者
Cury, Ricardo C. [1 ,2 ]
Feuchtner, Gudrun [1 ,2 ,3 ]
Mascioli, Carol [1 ,2 ]
Fialkow, Jonathon [1 ,2 ]
Andrulonis, Paul [1 ,2 ]
Villanueva, Tomas [1 ,2 ]
Pena, Constantino S. [1 ,2 ]
Janowitz, Warren R. [1 ,2 ]
Katzen, Barry T. [1 ,2 ]
Ziffer, Jack A. [1 ,2 ]
机构
[1] Baptist Hosp Miami, Miami, FL 33176 USA
[2] Baptist Cardiac & Vasc Inst, Miami, FL USA
[3] Innsbruck Med Univ, Dept Radiol 2, Innsbruck, Austria
关键词
Acute chest pain; emergency department; Coronary CTA; Nuclear Cardiology; non-invasive cardiac imaging; ACUTE CORONARY SYNDROME; ACUTE CHEST-PAIN; MULTIDETECTOR COMPUTED-TOMOGRAPHY; ELEVATION MYOCARDIAL-INFARCTION; NORTH-AMERICAN-SOCIETY; ASSOCIATION TASK-FORCE; ST-SEGMENT ELEVATION; LOW-RISK PATIENTS; MAGNETIC-RESONANCE; HEART-ASSOCIATION;
D O I
10.1007/s12350-011-9356-1
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
In clinical practice, assessment of chest pain patients presenting to the emergency department is difficult and the work-up can be lengthy and costly. There is growing evidence supporting the use of coronary computed tomography angiography (CTA) in early assessment of patients presenting with acute chest pain to the emergency department. CTA appears to be a faster and more accurate way to diagnosis or rule out coronary stenosis, leading to reduced hospital admissions, decreased time in the ED and lower costs. The focus of this article is to review the current literature of the use of Coronary CTA and "triple rule out" protocols in the emergency department setting and to provide a chest pain algorithm, showing how Coronary CTA can be implemented effectively in clinical practice. Potential pitfalls and requirements for implementation will also be discussed.
引用
收藏
页码:331 / 341
页数:11
相关论文
共 44 条
  • [1] Immediate exercise testing to evaluate low-risk patients presenting to the emergency department with chest pain
    Amsterdam, EA
    Kirk, JD
    Diercks, DB
    Lewis, WR
    Turnipseed, SD
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2002, 40 (02) : 251 - 256
  • [2] ACC/AHA 2007 guide lines for the management of patients with unstable Angina/Non-ST-Elevation myocardial infraction - Executive summary
    Anderson, Jeffrey L.
    Adams, Cynthia D.
    Antman, Elliott M.
    Bridges, Charles R.
    Califf, Robert M.
    Casey, Donald E., Jr.
    Chavey, William E., II
    Fesmire, Francis M.
    Hochman, Judith S.
    Levin, Thomas N.
    Lincoff, A. Michael
    Peterson, Eric D.
    Theroux, Pierre
    Wenger, Nanette Kass
    Wright, R. Scott
    Smith, Sidney C., Jr.
    Jacobs, Alice K.
    Adams, Cynthia D.
    Riegel, Barbara
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 50 (07) : 652 - 726
  • [3] Accuracy of biomarkers to diagnose acute cardiac ischemia in the emergency department: A meta-analysis
    Balk, EM
    Ioannidis, JPA
    Salem, D
    Chew, PW
    Lau, J
    [J]. ANNALS OF EMERGENCY MEDICINE, 2001, 37 (05) : 478 - 494
  • [4] ACC/AHA 2002 guideline update for the management of patients with unstable angina and non-ST-Segment elevation myocardial infarction - Summary article - A report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients with Unstable Angina)
    Braunwald, E
    Antman, EM
    Beasley, JW
    Califf, RM
    Cheitlin, MD
    Hochman, JS
    Jones, RH
    Kereiakes, D
    Kupersmith, J
    Levin, TN
    Pepine, CJ
    Schaeffer, JW
    Smith, EE
    Steward, DE
    Theroux, P
    Gibbons, RJ
    Alpert, JS
    Faxon, DP
    Fuster, V
    Gregoratos, G
    Hiratzka, LF
    Jacobs, AK
    Smith, SC
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2002, 40 (07) : 1366 - 1374
  • [5] Cardiac magnetic resonance with T2-weighted imaging improves detection of patients with acute coronary syndrome in the emergency department
    Cury, Ricardo C.
    Shash, Khalid
    Nagurney, John T.
    Rosito, Guido
    Shapiro, Michael D.
    Nomura, Cesar H.
    Abbara, Suhny
    Bamberg, Fabian
    Ferencik, Maros
    Schmidt, Ehud J.
    Brown, David F.
    Hoffmann, Udo
    Brady, Thomas J.
    [J]. CIRCULATION, 2008, 118 (08) : 837 - 844
  • [6] Radiation dose reduction by using 100-kV tube voltage in cardiac 64-slice computed tomography: A comparative study
    Feuchtner, Gudrun M.
    Jodocy, Daniel
    Klauser, Andrea
    Haberfellner, Bernhard
    Aglan, Iman
    Spoeck, Alexander
    Hiehs, Stefan
    Soegner, Peter
    Jaschke, Werner
    [J]. EUROPEAN JOURNAL OF RADIOLOGY, 2010, 75 (01) : E51 - E56
  • [7] The diagnostic accuracy of 64-slice computed tomography coronary angiography compared with stress nuclear imaging in emergency department low-risk chest pain patients
    Gallagher, Michael J.
    Ross, Michael A.
    Raff, Gilbert L.
    Goldstein, James A.
    O'Neill, William W.
    O'Neil, Brian
    [J]. ANNALS OF EMERGENCY MEDICINE, 2007, 49 (02) : 125 - 136
  • [8] Low Dose High-Pitch Spiral Acquisition 128-Slice Dual-Source Computed Tomography for the Evaluation of Coronary Artery Bypass Graft Patency
    Goetti, Robert
    Leschka, Sebastian
    Baumueller, Stephan
    Plass, Andre
    Wieser, Monika
    Desbiolles, Lotus
    Stolzmann, Paul
    Falk, Volkmar
    Marincek, Borut
    Alkadhi, Hatem
    Feuchtner, Gudrun
    [J]. INVESTIGATIVE RADIOLOGY, 2010, 45 (06) : 324 - 330
  • [9] GOLDSTEIN J, 2009, CORONARY COMPUTED TO
  • [10] A randomized controlled trial of multi-slice coronary computed tomography for evalation of acute chest pain
    Goldstein, James A.
    Gallagher, Michael J.
    O'Neill, William W.
    Ross, Michael A.
    O'Neil, Brian J.
    Raff, Gilbert L.
    [J]. JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY, 2007, 49 (08) : 863 - 871