The Radiologist as a Gatekeeper in Chest Pain

Silvia Pradella, Giulia Zantonelli, Giulia Grazzini, Diletta Cozzi, Ginevra Danti, Manlio Acquafresca and Vittorio Miele
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Silvia Pradella: Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
Giulia Zantonelli: Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
Giulia Grazzini: Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
Diletta Cozzi: Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
Ginevra Danti: Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
Manlio Acquafresca: Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
Vittorio Miele: Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy

IJERPH, 2021, vol. 18, issue 12, 1-11

Abstract: Chest pain is a symptom that can be found in life-threatening conditions such as acute coronary syndrome (ACS). Those patients requiring invasive coronary angiography treatment or surgery should be identified. Often the clinical setting and laboratory tests are not sufficient to rule out a coronary or aortic syndrome. Cardiac radiological imaging has evolved in recent years both in magnetic resonance (MR) and in computed tomography (CT). CT, in particular, due to its temporal and spatial resolution, the quickness of the examination, and the availability of scanners, is suitable for the evaluation of these patients. In particular, the latest-generation CT scanners allow the exclusion of diagnoses such as coronary artery disease and aortic pathology, thereby reducing the patient’s stay in hospital and safely selecting patients by distinguishing those who do not need further treatment from those who will need more- or less-invasive therapies. CT additionally reduces costs by improving long-term patient outcome. The limitations related to patient characteristics and those related to radiation exposure are weakening with the improvement of CT technology.

Keywords: chest pain; cardiac computed tomography (CCT); acute coronary syndrome (ACS); coronary artery disease (CAD); acute myocardial infarction (AMI); CAD diagnosis (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2021
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