Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Review
. 2010 May 25:6:307-16.
doi: 10.2147/vhrm.s9108.

Coronary computed tomographic angiography (CCTA) in community hospitals: "current and emerging role"

Rakesh K Sharma  1 , Donald J Voelker, Rajiv K Sharma, Vibhuti N Singh, Girish Bhatt, Mathilde Moazazi, Teresa Nash, Hanumanth K Reddy
Affiliations
Review

Coronary computed tomographic angiography (CCTA) in community hospitals: "current and emerging role"

Rakesh K Sharma et al. Vasc Health Risk Manag. .

Abstract

Coronary computed tomographic angiography (CCTA) is a rapidly evolving test for diagnosis of coronary artery disease. Although invasive coronary angiography is the gold standard for coronary artery disease (CAD), CCTA is an excellent noninvasive tool for evaluation of chest pain. There is ample evidence to support the cost-effective use of CCTA in the early triage process of patients presenting with chest pain in the emergency room. CCTA plays a critical role in the diagnosis of chest pain etiology as one of potentially fatal conditions, aortic dissection, pulmonary embolism, and myocardial infarction. This 'triple rule out' protocol is becoming an increasingly practicable and popular diagnostic tool in ERs across the country. In addition to a quick triage of chest pain patients, it may improve quality of care, decrease cost, and prevent medico-legal risk for missing potentially lethal conditions presenting as chest pain. CCTA is also helpful in the detection of subclinical and vulnerable coronary plaques. The major limitations for wide spread acceptance of this test include radiation exposure, motion artifacts, and its suboptimal imaging with increased body mass index.

Keywords: angiography; aortic dissection; calcium scoring; chest pain; community hospitals; computed tomography; coronary CTA; coronary artery disease (CAD); emergency room; pulmonary embolism.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Illustration of thin MIP reconstruction of left coronary artery. Note: Similarity of CCTA image to an angiographic appearance.
Figure 2
Figure 2
Illustration of soft and calcified plaque in proximal and mid LAD.
Figure 3
Figure 3
Patient presenting with acute chest pain; CCTA image showing large aortic root dissection.
Figure 4
Figure 4
Patient presenting with acute chest pain; CCTA image showing large right pulmonary artery embolism.
See this image and copyright information in PMC

Similar articles

See all similar articles

Cited by

See all "Cited by" articles

References

    1. Pitts SR, Niska RW, Xu J, Burt CW. National Hospital Ambulatory Medical Care Survey: 2006 emergency department summary. National Health Statistics Reports. 2008;7:20. - PubMed
    1. Flohr TG, McCollough CH, Bruder H, et al. First performance evaluation of a dual-source CT (DSCT) system. Eur Radiol. 2006;16(2):256–268. - PubMed
    1. Dey D, Lee CJ, Ohba M, et al. Image quality and artifacts in coronary CT angiography with dual-source CT: initial clinical experience. J Cardiovasc Comput Tomogr. 2008;2(2):105–114. - PubMed
    1. Fineberg HV, Scadden D, Goldman L. Care of patients with a low probability of acute myocardial infarction. Cost effectiveness of alternatives to coronary-care-unit admission. N Engl J Med. 1984;310(20):1301–1307. - PubMed
    1. McCarthy BD, Wong JB, Selker HP. Detecting acute cardiac ischemia in the emergency department: a review of the literature. J Gen Intern Med. 1990;5(4):365–373. - PubMed

MeSH terms