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Computed Tomography Angiographic Assessment of Acute Chest Pain
Matthew M Miller1, Carole A Ridge, Diana E Litmanovich
1*Department of Radiology, Duke University Hospital, Durham, NC ‡Department of Radiology, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA †Department of Radiology, Mater Misericordiae University Hospital, Dublin, Ireland.
Insights
Computed tomography angiography is crucial for diagnosing acute chest pain in emergency departments. This review highlights common imaging challenges in acquisition, interpretation, and communication to improve diagnostic accuracy.
Area of Science:
- Radiology
- Emergency Medicine
- Diagnostic Imaging
Background:
- Acute chest pain is a frequent reason for emergency department visits.
- Computed tomography angiography (CTA) is essential for diagnosing acute chest pain.
- Unrecognized imaging challenges can lead to misdiagnosis.
Purpose of the Study:
- To identify and illustrate common challenges in CTA for acute chest pain.
- To offer solutions for overcoming these imaging hurdles.
- To improve the accuracy of diagnosing acute chest pain in emergency settings.
Main Methods:
- Review of common challenges in CTA for acute chest pain.
- Categorization of challenges into image acquisition, interpretation, and communication.
- Illustration of challenges with examples.
Main Results:
- Identified challenges in image acquisition, interpretation (including mimics), and result communication.
- Provided practical solutions for each category of challenge.
- Emphasized the importance of recognizing and addressing these issues.
Conclusions:
- Addressing common CTA imaging challenges is vital for accurate acute chest pain diagnosis.
- Solutions provided aim to enhance diagnostic confidence and patient care.
- This review serves as a guide for emergency department imaging of acute chest pain.
Abstract:
Acute chest pain is a leading cause of Emergency Department visits. Computed tomography angiography plays a vital diagnostic role in such cases, but there are several common challenges associated with the imaging of acute chest pain, which, if unrecognized, can lead to an inconclusive or incorrect diagnosis. These imaging challenges fall broadly into 3 categories: (1) image acquisition, (2) image interpretation (including physiological and pathologic mimics), and (3) result communication. The aims of this review are to describe and illustrate the most common challenges in the imaging of acute chest pain and to provide solutions that will facilitate accurate diagnosis of the causes of acute chest pain in the emergency setting.