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Use of Multislice CT and MRI for the Evaluation of Patients with Chest Pain

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Book cover Short Stay Management of Chest Pain

Part of the book series: Contemporary Cardiology ((CONCARD))

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Abstract

Approximately 6 million patients are evaluated annually in United States emergency departments for acute chest pain (McCaig and Burt, National Hospital Ambulatory Medical Care Survey 2003. National Center for Health Statistics: Hyattsville, MD, 2005). Delineation of the presence or absence of an acute coronary syndrome must be accurate and efficient. The latest estimate is that 2% of patients with an acute coronary syndrome are inappropriately sent home from the emergency department (Pope et al. N Engl J Med 2000;342:1163–1170; Lee and Goldman, N Engl J Med 2000;342:1163–1170). These patients suffer higher morbidity than admitted patients. Missed ACS was the number one payout per case and that accounts for 41% of claims paid. So not surprisingly physicians do not want to miss ACS, resulting in an annual cost of US$10 to $13 billion to rule out ACS (McCaig and Burt, The National Hospital Ambulatory Medical Care Survey. Centers for Disease Control and Prevention’s National Center for Health Statistics, 2005).

Coronary CT angiography (CCTA) has great promise as a tool to expedite the triage of acute chest pain patients. The direct visualization of the coronary anatomy, the ability to simultaneously image the rest of the thorax to exclude aortic dissection and pulmonary embolism and the ability to provide alternate causes of chest pain, such as pneumonia, pericardial fluid, and esophageal inflammation. This chapter will examine the use of coronary CT angiography and MRI for the evaluation of acute chest pain.

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Authors and Affiliations

  1. Department of Emergency Medicine, William Beaumont Hospital, Royal Oak, MI, USA

    Brian O’Neil

  2. Department of Cardiology, William Beaumont Hospital, Royal Oak, MI, USA

    MD Michael J. Gallagher

  3. FACC William Beaumont Hospital, Royal Oak, MI, USA

    Gilbert L. Raff MD, FACC

Authors
  1. Brian O’Neil
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  2. MD Michael J. Gallagher
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  3. Gilbert L. Raff MD, FACC
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Correspondence to Brian O’Neil .

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    © 2009 Humana Press, a part of Springer Science+Business Media, LLC

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    O’Neil, B., Gallagher, M.J., Raff, G.L. (2009). Use of Multislice CT and MRI for the Evaluation of Patients with Chest Pain. In: Cannon, C., Peacock, W. (eds) Short Stay Management of Chest Pain. Contemporary Cardiology. Humana Press. https://doi.org/10.1007/978-1-60327-948-2_13

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    • DOI: https://doi.org/10.1007/978-1-60327-948-2_13

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    • Publisher Name: Humana Press

    • Print ISBN: 978-1-60327-947-5

    • Online ISBN: 978-1-60327-948-2

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