CAN COMPUTERIZED TOMOGRAPHIC ANGIOGRAPHY BE USED TO TRIAGE PATIENTS WITH CHEST PAIN PRESENTING TO THE EMERGENCY DEPARTMENT?
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Keywords:
Significant stenosis, Computerized Tomography (CT) angiography, Conventional angiography.
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Abstract
Objective: To confirm the findings of Computerized Tomography Angiography by invasive angiography.
Methodology: This comparative study on 50 patients fulfilling the inclusion criteria were admitted in
cardiology ward. Then they were shifted to catheterization lab of Lady Reading Hospital Peshawar for
invasive angiography and segmental analysis of all four vessels i.e. right coronary, left coronary
circumflex and left anterior descending artery was done.
Results: A total of 50 patients were studied both with CT angio and invasive angio and 750 segments were
analyzed for the 4 main arteries that is LMS, LAD, RCA and Circumflex. The sensitivity of CT angiography
for the LMS was 87.5%, Specificity 100%, PPV 100% and NPV 97.6%, PPV was 100% and NPV was also
100%. Similarly the diagnostic accuracy of CT angiography for the circumflex was sensitivity 100%,PPV
100% and NPV 97.91 to 100%. For RCA the sensitivity was from 60 to 100%, specificity 100%, PPV 100%
and NPV 95 to 100%.
Conclusion: Coronary CT angio with the highest resolution scanners could be a suitable means for rapid
triage of patients presenting to emergency departments with chest pain and for evaluation of patients with
equivocal stress test results who might otherwise need invasive angiography.
Methodology: This comparative study on 50 patients fulfilling the inclusion criteria were admitted in
cardiology ward. Then they were shifted to catheterization lab of Lady Reading Hospital Peshawar for
invasive angiography and segmental analysis of all four vessels i.e. right coronary, left coronary
circumflex and left anterior descending artery was done.
Results: A total of 50 patients were studied both with CT angio and invasive angio and 750 segments were
analyzed for the 4 main arteries that is LMS, LAD, RCA and Circumflex. The sensitivity of CT angiography
for the LMS was 87.5%, Specificity 100%, PPV 100% and NPV 97.6%, PPV was 100% and NPV was also
100%. Similarly the diagnostic accuracy of CT angiography for the circumflex was sensitivity 100%,PPV
100% and NPV 97.91 to 100%. For RCA the sensitivity was from 60 to 100%, specificity 100%, PPV 100%
and NPV 95 to 100%.
Conclusion: Coronary CT angio with the highest resolution scanners could be a suitable means for rapid
triage of patients presenting to emergency departments with chest pain and for evaluation of patients with
equivocal stress test results who might otherwise need invasive angiography.
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How to Cite
1.
Khan ZA, . S, Awan ZA. CAN COMPUTERIZED TOMOGRAPHIC ANGIOGRAPHY BE USED TO TRIAGE PATIENTS WITH CHEST PAIN PRESENTING TO THE EMERGENCY DEPARTMENT?. J Postgrad Med Inst [Internet]. 2012 Jun. 29 [cited 2024 Nov. 21];26(3). Available from: https://jpmi.org.pk/index.php/jpmi/article/view/1299
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