Master the evaluation of acute and chronic chest pain with coronary CT angiography (CCTA). We deconstruct this game changing technology w/experts from the Society for Cardiovascular Computed Tomography (SCCT), Dr. Todd Villines and Dr. Ahmad Slim. We’ve got answers on what to do when a patient with chest pain has a prior CAC score of zero, and/or a CCTA with non-obstructive disease. Plus: how to select, prepare, and counsel patients; how to interpret reports; choosing between myocardial perfusion study and CCTA, and more!
Special thanks to Dr. Emilio Fentanes from SCCT for setting up this interview.
Full show notes available at http://thecurbsiders.com/podcast
Case: 45 yo F active duty Colonel with chronic chest pain syndrome despite negative conventional stress test and CAC score of zero.
04:00 Rapid fire questions
08:23 Book recommendations
10:14 Defining terms CCTA vs CAC
12:47 Script for counseling patient about CCTA
14:34 Prep for CCTA
16:40 Why is CCTA controversial?
19:37 Patient selection for CCTA both acute and chronic
25:20 Chronic chest pain and CCTA
27:58 CAC and CCTA in high risk occupations
33:25 Clinical case
36:10 Acute chest pain in patient w/CAC score zero
39:18 Acute chest pain in patient w/CAC score zero and previous CCTA w/non-obstructive CAD
41:22 How to read a CCTA report
45:48 CCTA versus conventional testing and risk MI, death
49:18 Use of CCTA in outpatients
52:16 Plaque characteristics and risk ACS
55:51 CCTA w/non-obstructive disease in patients with acute chest pain
58:14 When is myocardial perfusion scanning better?
61:00 Listener question on small vessel disease
62:09 Take home points
65:00 Curbsiders recap