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Chronic Chest Pain

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CT of the Heart

Part of the book series: Contemporary Medical Imaging ((CMI))

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Abstract

Coronary computed tomography angiography (CTA) is increasingly applied for diagnosing coronary artery disease (CAD) in patients with chronic chest pain. Coronary CTA is a fast noninvasive test, which besides the detection of obstructive stenosis has the unique capability to identify also non-obstructive stenosis. Stable angina is typically characterized by episodes of myocardial ischemia due to a mismatch between oxygen demand and supply. The main causes of myocardial ischemia, which can be discerned, are CAD, microvascular disease, vasospasm, ischemic cardiomyopathy, and coronary anomaly. Beyond the identification of CAD, CTA enables myocardial perfusion imaging thus the detection of ischemic areas; furthermore by using prospectively ECG-triggered dual-step pulsing or retrospective gating, it allows to assess wall motion abnormalities. Recently two large randomized controlled trials, PROMISE and SCOT-HEART, reignited the discussion on the use of coronary CTA. In this chapter the role of coronary CTA for diagnosing, prognostication, and treatment will be discussed for patients with chronic chest pain.

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Authors and Affiliations

  1. Department of Radiology, University Medical Center Utrecht, Utrecht, The Netherlands

    Richard A. P. Takx

  2. Department of Radiology, Heart and Vascular Center, Semmelweis University, Budapest, Hungary

    Csilla Celeng

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  1. Richard A. P. Takx
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Correspondence to Richard A. P. Takx .

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  1. Department of Radiology, Center for Advanced Imaging Research (CAIR), Medical University of South Carolina, Charleston, SC, USA

    U. Joseph Schoepf

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Takx, R.A.P., Celeng, C. (2019). Chronic Chest Pain. In: Schoepf, U. (eds) CT of the Heart. Contemporary Medical Imaging. Humana, Totowa, NJ. https://doi.org/10.1007/978-1-60327-237-7_27

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