A New Way To Rule Out A Heart Attackby William Kay, MD on 04/13/12
A non-invasive CT scan (CAT scan) is proving to be 100% accurate in ruling out heart attacks when people present to an E.R. for chest pain (coronary artery occlusion leading to an ischemic event). Technically, the scan is called a CCTA which stands for Coronary computed tomographic angiography.
Traditionally, patients who present with chest pain suspicious of a heart attack receive a broad number of laboratory tests, EKG, and admission overnight for observation. With the new studies showing 100% negative predictive value of a CCTA in ruling out heart attacks as a cause for chest pain, patients and doctors have a strong new option.
Advantages include less blood work, less hospital time, and a very strong assurance on discharge to the patient that they do not have heart vessel disease.
Disadvantages include the radiation received from the scan and a possible reaction to the contrast dye used during the procedure. The scan also usually involves the patient taking two medications to make the scan optimal (a beta-blocker to slow the heart rate and nitroglycerin to dilate the blood vessels).
The New England Journal of Medicine has a full article in their April 12th, 2012 edition.
As always, I am neither endorsing nor condemning this diagnostic modality. My position is one of education so that health care providers and patients can make informed decisions.
William N. Kay, MD