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Cardiac CT in the Emergency Department

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Atlas of Cardiovascular Computed Tomography

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Abstract

Acute chest pain is one of the most common chief complaints in patients presenting to the emergency department (ED) in the United States, accounting for approximately seven million visits every year [1]. Accurate early triage of these patients remains a major diagnostic challenge, as an acute coronary syndrome (ACS) is ultimately diagnosed in only 2–8% of these patients [2]. Clinical presentation, chest pain history, and clinical risk factors are important in the evaluation of patients, but they do not allow for a definitive exclusion of ACS [3], so the standard of care for patients with acute chest pain includes serial electrocardiograms and troponin measurements, often in chest pain observation units, followed by more advanced diagnostic testing with or without imaging (Fig. 10.1) [4–9]. Despite this conservative practice, which is associated with high costs, about 2% of patients with ACS are inappropriately discharged [10]. Therefore, diagnostic strategies that lead to rapid and reliable early triage of patients with acute chest pain are desirable.

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Acknowledgment

Dr. Ferencik received support from the American Heart Association (13FTF16450001).

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Authors and Affiliations

  1. Knight Cardiovascular Institute, Oregon Health and Science University, 3181 SW Sam Jackson Park Road, Portland, OR, 97239, USA

    Maros Ferencik

  2. Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA

    Khristine Ghemigian

  3. Department of Radiology, Massachusetts General Hospital, Boston, MA, USA

    Udo Hoffmann

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  1. Maros Ferencik
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  2. Khristine Ghemigian
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  3. Udo Hoffmann
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Correspondence to Maros Ferencik .

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Editors and Affiliations

  1. Los Angeles Biomedical Research Institute, UCLA, Torrance, California, USA

    Matthew J. Budoff

  2. Department of Cardiology, Universitätsklinikum Erlangen, Erlangen, Germany

    Stephan S. Achenbach

  3. Mount Sinai Hospital, New York City, New York, USA

    Harvey S. Hecht

  4. Department of Cardiology , Mount Sinai Hospital, New York, New York, USA

    Jagat Narula

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Ferencik, M., Ghemigian, K., Hoffmann, U. (2018). Cardiac CT in the Emergency Department. In: Budoff, M., Achenbach, S., Hecht, H., Narula, J. (eds) Atlas of Cardiovascular Computed Tomography. Springer, London. https://doi.org/10.1007/978-1-4471-7357-1_10

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