Leslee Shaw, PhD, FACC, MASNC, FAHA, FSCCT, clinical scientist and director of The Blavatnik Family Women’s Health Research Institute, Mount Sinai Hospital, New York, and former president of both the Society of Cardiovascular Computed Tomography (SCCT) and the American Society of Nuclear Cardiology (ASNC), explains the role of cardiac computed tomography (CT) in the recent 2021 chest pain guidelines. She spoke at the American College of Cardiology (ACC) 2022 meeting on the first guidelines established for assessing patients with chest pain in the fall of 2021, which elevated cardiac CT to recommended front-line imaging modality.
Cardiac CT and fractional flow reserve CT (FFR-CT) were included as front-line tests in 2021 chest pain evaluation guidelines. CTA was given a 1A level of evidence, the highest value, for imaging chest pain patients. Most chest pain patients who come into emergency rooms do not have a heart attack, and CT has been proved to quickly rule out coronary artery involvement so patients can be discharged more quickly and with fewer tests.
FFR-CT uses CT scans an a super-computing algorithm to create 3D images of a patient's coronary artery tree and show hemodynamic blood flow values in each vessel. This allows CT, traditionally an anatomical imaging modality, to offer physiologic data as well from one test. The FFR color coded vessels can help pin point the location of a blocked artery causing a myocardial infarction and offer a roadmap for interventional cardiologists in the cath lab. The FFR values also can show if a coronary lesion is not significant enough to require a stent and can be treated with drugs, so it can act as a gate keeper to the cath lab and help eliminate the need for diagnostic angiograms.
Related Cardiac CT Content:
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Dave Fornell has covered healthcare for more than 17 years, with a focus in cardiology and radiology. Fornell is a 5-time winner of a Jesse H. Neal Award, the most prestigious editorial honors in the field of specialized journalism. The wins included best technical content, best use of social media and best COVID-19 coverage. Fornell was also a three-time Neal finalist for best range of work by a single author. He produces more than 100 editorial videos each year, most of them interviews with key opinion leaders in medicine. He also writes technical articles, covers key trends, conducts video hospital site visits, and is very involved with social media. E-mail: dfornell@innovatehealthcare.com