Sarto Gianmarco, Simeone Beatrice, Spadafora Luigi, Bernardi Marco, Rocco Erica, Pelle Giuseppe, Liberati Quirino, Forte Maurizio, Schirone Leonardo, Versaci Francesco, Piaz Rita Dal, Palmerio Silvia, Barberi Antonio, Frati Giacomo, Bellini Davide, Rengo Marco, Carbone Iacopo, Sciarretta Sebastiano, Valenti Valentina
ICOT Istituto Marco Pasquali, Via Franco Faggiana 1668, Latina, 04100, Italy.
Department of Diagnostic and Interventional Radiology, 'Santa Maria Goretti' Hospital, Latina, Italy.
Int J Cardiovasc Imaging. 2024 Dec;40(12):2447-2457. doi: 10.1007/s10554-024-03274-w. Epub 2024 Nov 14.
Acute chest pain (ACP) is a frequent cause of Emergency Department (ED) admissions, with millions of cases reported globally each year. Timely and accurate diagnosis is crucial due to the wide range of underlying causes, such as acute coronary syndrome (ACS), pulmonary embolism (PE), aortic dissection, and others. Misdiagnosis can lead to missed life-saving interventions or, alternatively, unnecessary hospitalizations, escalating healthcare costs. While risk stratification tools like the HEART, GRACE, and TIMI scores are useful, additional imaging is often required to achieve diagnostic precision. Coronary computed tomography angiography (CCTA) has shown significant potential in enhancing diagnostic accuracy and improving patient outcomes. In this review, we explore the challenges physicians encounter when evaluating ACP in the ED, emphasizing the utility of CCTA as a key diagnostic tool. Additionally, we present a clinical case that illustrates how CT scan effectively aids in diagnosing patients with ambiguous symptoms, with CT imaging playing a pivotal role in identifying the underlying pathology.
急性胸痛(ACP)是急诊科(ED)收治患者的常见原因,全球每年报告数百万病例。由于潜在病因范围广泛,如急性冠状动脉综合征(ACS)、肺栓塞(PE)、主动脉夹层等,及时准确的诊断至关重要。误诊可能导致错过挽救生命的干预措施,或者导致不必要的住院治疗,增加医疗费用。虽然像HEART、GRACE和TIMI评分等风险分层工具很有用,但通常还需要额外的影像学检查来实现诊断的精确性。冠状动脉计算机断层扫描血管造影(CCTA)在提高诊断准确性和改善患者预后方面已显示出巨大潜力。在本综述中,我们探讨了医生在急诊科评估ACP时遇到的挑战,强调了CCTA作为关键诊断工具的实用性。此外,我们还展示了一个临床病例,说明CT扫描如何有效地帮助诊断症状不明确的患者,CT成像在识别潜在病理方面发挥了关键作用。