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Coronary Computed Tomographic Angiography

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Presentation on theme: "Coronary Computed Tomographic Angiography"— Presentation transcript:

1 Coronary Computed Tomographic Angiography
by Michael K. Cheezum, and Ron Blankstein Circulation Volume 130(23): December 2, 2014 Copyright © American Heart Association, Inc. All rights reserved.

2 A, Proposed testing strategy in patients with possible acute coronary syndrome (ACS). *Contraindications to computed tomographic angiography (CTA) include renal disease, severe allergy to iodine contrast, inability to follow breath-hold instructions, and pregnancy. A, Proposed testing strategy in patients with possible acute coronary syndrome (ACS). *Contraindications to computed tomographic angiography (CTA) include renal disease, severe allergy to iodine contrast, inability to follow breath-hold instructions, and pregnancy. Also consider factors that may impair image quality: body mass index >40 kg/m2, arrhythmias, high heart rate despite β-blockers, extensive coronary calcifications, and intolerance or contraindication to β-blockers or nitroglycerin. Adapted from Cheezum et al11 with permission from the publisher. Copyright © 2014 Informa Plc. Authorization for this adaptation has been obtained both from the owner of the copyright in the original work and from the owner of copyright in the translation or adaptation. B, Early imaging strategy implementing coronary CTA. CAD indicates coronary artery disease. Adapted from Cheezum et al11 with permission from the publisher. Copyright © 2014 Informa Plc. Authorization for this adaptation has been obtained both from the owner of the copyright in the original work and from the owner of copyright in the translation or adaptation. Michael K. Cheezum, and Ron Blankstein Circulation. 2014;130: Copyright © American Heart Association, Inc. All rights reserved.

3 The 2010 computed tomographic angiography (CTA) appropriate use criteria in patients with acute chest pain. The 2010 computed tomographic angiography (CTA) appropriate use criteria in patients with acute chest pain. CAD indicates coronary artery disease; and MI, myocardial infarction. Adapted from Taylor et al.5 Michael K. Cheezum, and Ron Blankstein Circulation. 2014;130: Copyright © American Heart Association, Inc. All rights reserved.

4 Coronary computed tomographic angiography (CTA) demonstrating nonobstructive coronary artery disease. Coronary computed tomographic angiography (CTA) demonstrating nonobstructive coronary artery disease. Top row, Three-dimensional and curved multiplanar views of the left anterior descending artery (LAD), left circumflex artery (LCX), and right coronary artery (RCA). There is noncalcified and calcified plaque in the proximal and mid-LAD, resulting in mild (25%–49%) stenosis. Bottom row, Orthogonal and short-axis views of mid-LAD demonstrating (b) predominant calcified plaque in the mid-LAD, resulting in mild (25%–49%) stenosis relative to (a) proximal and (c) distal reference vessels. Michael K. Cheezum, and Ron Blankstein Circulation. 2014;130: Copyright © American Heart Association, Inc. All rights reserved.


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