Use of multidetector computed tomography for the assessment of acute chest pain: a consensus statement of the North American Society of Cardiac Imaging and the European Society of Cardiac Radiology

Stillman, Arthur E.; Oudkerk, Matthijs; Ackerman, Margaret; Becker, Christoph; Buszman, Paweł; Feyter, Pim J. de; Hoffmann, Udo; Keadey, Matthew T.; Marano, Riccardo; Lipton, Martin J.; Raff, Gilbert; Reddy, Gautham P.; Rees, Michael R.; Rubin, Geoffrey D.; Schoepf, U. Joseph; Tarulli, Giuseppe; Beek, Edwin Jacques Rudolph van; Wexler, Lewis; White, Charles S.

doi:10.1007/s00330-007-0677-z

Cited by 65 publications

(27 citation statements)

References 54 publications

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“…This body of evidence supporting the use of Coronary CTA in the triage of chest pain patients presenting to the emergency department is beginning to be translated in medical societal consensus statement and appropriate use guidelines. 43,44 A TRO protocol may be considered if an additional suspicion of pulmonary embolism or acute aortic disease is present, when using a CT with 64-slices or more. Radiation and contrast exposure needs to be balanced and outweighed with risks and benefits when using 64-slice CT, and low-radiation dose CT scan techniques applied whenever possible.…”

Section: Resultsmentioning

confidence: 99%

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

Cury

Feuchtner

Mascioli

et al. 2011

Journal of Nuclear Cardiology

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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.

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Section: Resultsmentioning

confidence: 99%

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

Cury

Feuchtner

Mascioli

et al. 2011

Journal of Nuclear Cardiology

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“…Für weitere lebensbedrohliche Differenzialdiagnosen des Thoraxschmerzes wie Perikardtamponade, Ösophagusrup-tur und Spannungspneumothorax ist die CT ebenfalls geeignet, auch wenn sie hier nicht dem Goldstandard entspricht und andere, weniger invasive Untersuchungsmethoden zur Verfügung stehen [26]. Gerade die Diagnose des ACS, einschließlich instabiler Angina pectoris, Nicht-ST-Hebungsinfarkt ("non-ST-elevation myocardial infarction", NSTEMI) und ST-Hebungsinfarkt ("ST-elevation myocardial infarction", STEMI), spielt eine wichtige Rolle.…”

Section: > Brustschmerzen Stellen Eine Große Klinische Herausforderununclassified

“…inkonklusiven Laborbefunden mit klinisch weiterhin bestehendem Verdacht auf eine KHK indiziert [26]. Bei negativen D-Dimeren und negativem Wells-Score ist der Wechsel zu einem "Double-rule-out"-Protokoll mit geringerer Kontrastmittelmenge und kleinerem Untersuchungsgebiet ausreichend.…”

Section: Sorgfältige Patientenselektionunclassified

„Triple-rule-out“-Computertomographie in der Notaufnahme

Stoevesandt

Buerke

2011

Med Klin

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In the emergency department patients with chest pain play an important role because the underlying and concealed diseases can be life-threatening. The complaints are often nonspecific and patients also have different risk profiles. In patients in the emergency department with nonspecific chest pain a"1-stop strategy" for elucidation of the three main organs lung, hear and aorta with the 4 main differential diagnoses (aortic dissection, ruptured aortic aneurysm, pulmonary embolism and coronary heart disease) is desirable. Technical advances in computed tomography (CT) in recent years make this approach technically possible. In modern emergency departments CT equipment is becoming more and more common in order to rapidly examine trauma patients. A meaningful patient selection and preparation are, however, necessary to avoid unnecessary exposure of patients to contrast media and radiation. In this way it is possible to reduce the rate of overlooked diseases or false diagnoses.

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“…The speed and the increased availability of multidetector CT (MDCT), has meant that MDCT is now the initial investigation for many causes of chest pain [1]. Indeed MDCT is now the "gold standard" for the assessment of the suspected acute aortic syndrome.…”

Section: Introductionmentioning

confidence: 99%

A case report of a normal aorta misdiagnosed as type A dissection by modern multidetector computed tomography

et al. 2010

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Use of multidetector computed tomography for the assessment of acute chest pain: a consensus statement of the North American Society of Cardiac Imaging and the European Society of Cardiac Radiology

Cited by 65 publications

References 54 publications

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

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

„Triple-rule-out“-Computertomographie in der Notaufnahme

A case report of a normal aorta misdiagnosed as type A dissection by modern multidetector computed tomography

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