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09-05-2023 | Computed Tomography | Commentary

How to set up a 24/7 cardiac computed tomography service in an emergency department

Authors: Christian Loewe, Dietrich Beitzke, Marco Francone

Published in: European Radiology | Issue 11/2023

Excerpt

The current guidelines in the management of acute and chronic chest pain increasingly recommend the early use of cardiac computed tomography (CT) [1, 2] as a first-line test depending on the pretest probability due to its high negative predictive value, its ability to significantly shorten the length of stay in the chest pain unit (CPU) [3, 4], and its power to improve the outcome by reducing future coronary events and cardiac-related death [5, 6]. Consequently, the question of time for all institutions providing 24/7 CT service related to an Emergency Department and/or CPU is not if they want to provide 24/7 Cardiac CT service, but how they facilitate it. …

Greer C, Williams MC, Newby DE, Adamson PD (2023) Role of computed tomography cardiac angiography in acute chest pain syndromes. Heart. https://doi.org/10.1136/heartjnl-2022-321360CrossRefPubMed

Knuuti J, Wijns W, Saraste A et al (2020) ESC Scientific Document Group. 2019 ESC guidelines for the diagnosis and management of chronic coronary syndromes. Eur Heart J 41(3):407–477. https://doi.org/10.1093/eurheartj/ehz425

Goehler A, Mayrhofer T, Pursnani A et al (2020) Long-term health outcomes and cost-effectiveness of coronary CT angiography in patients with suspicion for acute coronary syndrome. J Cardiovasc Comput Tomogr 14(1):44–54. https://doi.org/10.1016/j.jcct.2019.06.008CrossRefPubMed

Truong QA, Schulman-Marcus J, Zakroysky P et al (2016) Coronary CT angiography versus standard emergency department evaluation for acute chest pain and diabetic patients: is there benefit with early coronary CT angiography? Results of the randomized comparative effectiveness ROMICAT II Trial. J Am Heart Assoc 5(3):e003137. https://doi.org/10.1161/JAHA.115.003137

SCOT-HEART Investigators, Newby DE, Adamson PD et al (2018) Coronary CT angiography and 5-year risk of myocardial infarction. N Engl J Med. 379(10):924-933. https://doi.org/10.1056/NEJMoa1805971

Williams MC, Moss AJ, Dweck M et al (2019) Coronary artery plaque characteristics associated with adverse outcomes in the SCOT-HEART Study. J Am Coll Cardiol 73(3):291–301. https://doi.org/10.1016/j.jacc.2018.10.066CrossRefPubMedPubMedCentral

van den Boogert TPW, Claessen BEPM, Boekholdt SM et al (2021) The impact and challenges of implementing CTCA according to the 2019 ESC guidelines on chronic coronary syndromes: a survey and projection of CTCA services in the Netherlands. Insights Imaging 12(1):186. https://doi.org/10.1186/s13244-021-01122-2CrossRefPubMedPubMedCentral

European Society of Radiology (ESR) (2012) Editorial on the revised European Training Charter for Clinical Radiology. Insights Imaging 3(1):5-6. https://doi.org/10.1007/s13244-011-0143-y

European Diploma in Cardiovascular Radiology (EBCR). Diploma. https://www.escr.org/diploma/

10.

Natale L, Vliegenthart R, Salgado R et al (2023) Cardiac radiology in Europe: status and vision by the European Society of Cardiovascular Radiology (ESCR) and the European Society of Radiology (ESR). Eur Radiol. https://doi.org/10.1007/s00330-023-09533-zCrossRefPubMedPubMedCentral

Title: How to set up a 24/7 cardiac computed tomography service in an emergency department
Authors: Christian Loewe
Dietrich Beitzke
Marco Francone
Publication date: 09-05-2023
Publisher: Springer Berlin Heidelberg
Keywords: Computed Tomography
Computed Tomography
Published in: European Radiology / Issue 11/2023
Print ISSN: 0938-7994
Electronic ISSN: 1432-1084
DOI: https://doi.org/10.1007/s00330-023-09721-x

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How to set up a 24/7 cardiac computed tomography service in an emergency department

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