VIDEO: The new role of cardiac CT in chest pain evaluation
Brian Ghoshhajra, MD, MBA, division chief, cardiovascular imaging, Massachusetts General Hospital and associate professor of radiology, Harvard Medical School, and a board member of the Society of Cardiovascular Computed Tomography (SCCT), explains the rapidly expanding interest in cardiac computed tomography (CT) under the new chest pain evaluation guidelines.
He outlines the ACC 2021 Chest Pain Evaluation Guidelines, what is needed to perform cardiac CT angiography (CTA), how CTA can help speed patient triage in the emergency department (ED) and how it can help avoid invasive angiography in the cath lab. He said mass General has been using CTA as a primary test to evaluate chest pain patients since 2014.
"It's a disruptive technology," Ghoshhajra explained. "It can certainly obliviate the need for invasive tests. What is well codified in the new guidelines is that there are many first line test for different types of patients, and sometimes there are choices. We strongly feel CT is often a first-line test, more so than what prior guidelines had reflected. I would say the first-line indication is highly appropriate in a large and ever growing number of patients."
He said CTA can help speed patient triage and determine if a patient is having a coronary issue or not pretty quickly
He said most EDs now have 64-slice and greater CT scanners that are cardiac capable. But, he said creating a cardiac CT program does require expertise so staff may require additional training.
"It does require expertise, both on the acquisition as well as the interpretation side of things," he said.
Ghoshhajra also explains the role of FFR-CT, which was specifically included in the guidelines to help pull additional diagnostic information from CTA scans when it is unclear if a patient's plaque burden is causing chest pain, or to determine if a patient can be managed medically.
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Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com