Department of Cardiac Computed Tomography, St Thomas' Hospital, London, UK.
Int J Clin Pract. 2011 Dec;65(12):1267-73. doi: 10.1111/j.1742-1241.2011.02788.x.
Acute chest pain is a common presenting complaint of patients attending emergency room departments. Despite this, it can often be challenging to completely exclude a diagnosis of acute coronary syndrome following an initial standard clinical and biochemical evaluation. As a result of this, patients are often admitted to hospital until the treating clinician is satisfied that this diagnosis can be excluded. This process imparts a significant health economic burden by not only increasing hospital bed occupancy rates but also by the unnecessary layering of diagnostic investigations. With the rapid advances in coronary computed tomography angiography (CTA), there has been considerable interest in whether coronary CTA may be a viable alternative to this current standard care. We review the current literature and supporting evidence for utilising coronary CTA in the evaluation of patients presenting with acute chest pain in terms of its diagnostic accuracy, safety, cost-effectiveness and prognostic implications.
急性胸痛是患者就诊急诊科室的常见主诉。尽管如此，在初始标准临床和生化评估后，要完全排除急性冠状动脉综合征的诊断通常具有挑战性。因此，患者通常会被收治住院，直到治疗医生确信可以排除该诊断。这一过程不仅增加了医院床位占用率，还增加了不必要的诊断性检查，从而给医疗经济带来了巨大的负担。随着冠状动脉计算机断层扫描血管造影术（CTA）的快速发展，人们对 CTA 是否可以替代目前的标准治疗方法产生了浓厚的兴趣。我们回顾了目前关于在急性胸痛患者评估中使用冠状动脉 CTA 的文献和支持证据，包括其诊断准确性、安全性、成本效益和预后意义。
