ROLE OF CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IN EMERGENCY DEPARTMENT
Karim Essam Mohammed;
Abstract
Coronary artery disease (CAD) is the leading cause of death and disability worldwide, and its prevalence is expected to increase in the coming years. CAD events are caused by the interplay of genetic and environmental factors, the effects of which are mainly mediated through cardiovascular risk factors.
Although diagnostic invasive coronary angiography (ICA) can directly and precisely visualize the stenotic lumen of the coronary artery, it is an invasive and expensive examination, accompanied by the risk of major complications. Therefore, a non-invasive test for the assessment of the coronary arteries is highly desirable.
With the development of multidetector computed tomography (MDCT), CT angiography (CTA) has been applied widely as an clinical tool for evaluating CAD.
Coronary CT angiography has emerged as an alternative to conventional coronary angiography with high spatial resolution , sensitivity and specificity.
Many patients with acute chest pain are also not very likely to have coronary artery disease, especially if their ECG is normal. coronary CT angiography may be very useful in these patients to rapidly assess the presence or coronary stenosis and determine the necessity of further treatment.
The aim and key role of coronary CTA is to differentiate patients with normal coronary vessels from those with limited atherosclerotic involvement without evidence of stenosis (who may benefit from supportive drug therapy) and from those with significant stenosis.
A safe and efficient clinical decision rule or diagnostic test for patients with a possible acute coronary syndrome is highly desirable. Acute chest-pain syndromes are the second most common reason for emergency department visits, Although an acute coronary syndrome is ultimately diagnosed in only 10 to 15% of patients who present with chest pain, the majority of these patients are admitted to hospitals.
We found that 50% of patients whose symptoms were evaluated with the use of a CCTA-based strategy were discharged home from the emergency department. This was more than double the rate of discharge among patients in the traditional-care group and exceeds typical rates in this patient population.
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.
Although diagnostic invasive coronary angiography (ICA) can directly and precisely visualize the stenotic lumen of the coronary artery, it is an invasive and expensive examination, accompanied by the risk of major complications. Therefore, a non-invasive test for the assessment of the coronary arteries is highly desirable.
With the development of multidetector computed tomography (MDCT), CT angiography (CTA) has been applied widely as an clinical tool for evaluating CAD.
Coronary CT angiography has emerged as an alternative to conventional coronary angiography with high spatial resolution , sensitivity and specificity.
Many patients with acute chest pain are also not very likely to have coronary artery disease, especially if their ECG is normal. coronary CT angiography may be very useful in these patients to rapidly assess the presence or coronary stenosis and determine the necessity of further treatment.
The aim and key role of coronary CTA is to differentiate patients with normal coronary vessels from those with limited atherosclerotic involvement without evidence of stenosis (who may benefit from supportive drug therapy) and from those with significant stenosis.
A safe and efficient clinical decision rule or diagnostic test for patients with a possible acute coronary syndrome is highly desirable. Acute chest-pain syndromes are the second most common reason for emergency department visits, Although an acute coronary syndrome is ultimately diagnosed in only 10 to 15% of patients who present with chest pain, the majority of these patients are admitted to hospitals.
We found that 50% of patients whose symptoms were evaluated with the use of a CCTA-based strategy were discharged home from the emergency department. This was more than double the rate of discharge among patients in the traditional-care group and exceeds typical rates in this patient population.
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.
Other data
| Title | ROLE OF CORONARY COMPUTED TOMOGRAPHY ANGIOGRAPHY IN EMERGENCY DEPARTMENT | Other Titles | دورالتصوير المقطعي للشرايين التاجية في قسم الطوارئ | Authors | Karim Essam Mohammed | Issue Date | 2014 |
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