Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives
About 5% of annual access to emergency departments (EDs) and up to 25–30% of hospital admissions involve patients with symptoms suggestive of acute coronary syndrome (ACS). The process of evaluating and treating these patients is highly challenging for clinicians because failing to correctly identif...
Saved in:
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-01-01
|
| Series: | Journal of Cardiovascular Development and Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2308-3425/12/2/48 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849719510420946944 |
|---|---|
| author | Antonio De Vita Marcello Covino Sara Pontecorvo Giacomo Buonamassa Angelo Giuseppe Marino Riccardo Marano Luigi Natale Giovanna Liuzzo Francesco Burzotta Francesco Franceschi |
| author_facet | Antonio De Vita Marcello Covino Sara Pontecorvo Giacomo Buonamassa Angelo Giuseppe Marino Riccardo Marano Luigi Natale Giovanna Liuzzo Francesco Burzotta Francesco Franceschi |
| author_sort | Antonio De Vita |
| collection | DOAJ |
| description | About 5% of annual access to emergency departments (EDs) and up to 25–30% of hospital admissions involve patients with symptoms suggestive of acute coronary syndrome (ACS). The process of evaluating and treating these patients is highly challenging for clinicians because failing to correctly identify an ACS can result in fatal or life-threatening consequences. However, about 50–60% of these patients who are admitted to the hospital because of chest pain are found to have no ACS. Coronary computed tomographic angiography (CCTA) has emerged as a proposed new frontline test for managing acute chest pain in the ED, particularly for patients with low-to-intermediate risk. This narrative review explores the potential of adopting an early CCTA-based approach in the ED, its significance in the era of high-sensitivity troponins, its application to high-risk patients and its prognostic value concerning atherosclerotic burden and high-risk plaque features. Additionally, we address clinical and technical issues related to CCTA use for triaging acute chest pain in the ED, as well as the role of functional testing. Finally, we aim to provide insight into future perspectives for the clinical application of CCTA in the ED. |
| format | Article |
| id | doaj-art-9e52ad3ea3014c26bf37ffc7ec9e5f22 |
| institution | DOAJ |
| issn | 2308-3425 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Cardiovascular Development and Disease |
| spelling | doaj-art-9e52ad3ea3014c26bf37ffc7ec9e5f222025-08-20T03:12:08ZengMDPI AGJournal of Cardiovascular Development and Disease2308-34252025-01-011224810.3390/jcdd12020048Coronary CT Angiography in the Emergency Department: State of the Art and Future PerspectivesAntonio De Vita0Marcello Covino1Sara Pontecorvo2Giacomo Buonamassa3Angelo Giuseppe Marino4Riccardo Marano5Luigi Natale6Giovanna Liuzzo7Francesco Burzotta8Francesco Franceschi9Faculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyFaculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyFaculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyFaculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyFaculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyFaculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyFaculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyFaculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyFaculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyFaculty of Medicine and Surgery, Catholic University of the Sacred Heart, 00168 Rome, ItalyAbout 5% of annual access to emergency departments (EDs) and up to 25–30% of hospital admissions involve patients with symptoms suggestive of acute coronary syndrome (ACS). The process of evaluating and treating these patients is highly challenging for clinicians because failing to correctly identify an ACS can result in fatal or life-threatening consequences. However, about 50–60% of these patients who are admitted to the hospital because of chest pain are found to have no ACS. Coronary computed tomographic angiography (CCTA) has emerged as a proposed new frontline test for managing acute chest pain in the ED, particularly for patients with low-to-intermediate risk. This narrative review explores the potential of adopting an early CCTA-based approach in the ED, its significance in the era of high-sensitivity troponins, its application to high-risk patients and its prognostic value concerning atherosclerotic burden and high-risk plaque features. Additionally, we address clinical and technical issues related to CCTA use for triaging acute chest pain in the ED, as well as the role of functional testing. Finally, we aim to provide insight into future perspectives for the clinical application of CCTA in the ED.https://www.mdpi.com/2308-3425/12/2/48coronary computed tomographic angiographyemergency departmentacute chest painacute coronary syndromecoronary artery disease |
| spellingShingle | Antonio De Vita Marcello Covino Sara Pontecorvo Giacomo Buonamassa Angelo Giuseppe Marino Riccardo Marano Luigi Natale Giovanna Liuzzo Francesco Burzotta Francesco Franceschi Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives Journal of Cardiovascular Development and Disease coronary computed tomographic angiography emergency department acute chest pain acute coronary syndrome coronary artery disease |
| title | Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives |
| title_full | Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives |
| title_fullStr | Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives |
| title_full_unstemmed | Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives |
| title_short | Coronary CT Angiography in the Emergency Department: State of the Art and Future Perspectives |
| title_sort | coronary ct angiography in the emergency department state of the art and future perspectives |
| topic | coronary computed tomographic angiography emergency department acute chest pain acute coronary syndrome coronary artery disease |
| url | https://www.mdpi.com/2308-3425/12/2/48 |
| work_keys_str_mv | AT antoniodevita coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives AT marcellocovino coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives AT sarapontecorvo coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives AT giacomobuonamassa coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives AT angelogiuseppemarino coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives AT riccardomarano coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives AT luiginatale coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives AT giovannaliuzzo coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives AT francescoburzotta coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives AT francescofranceschi coronaryctangiographyintheemergencydepartmentstateoftheartandfutureperspectives |