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The Radiologist as a Gatekeeper in Chest Pain

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  • Silvia Pradella

    (Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
    Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy)

  • Giulia Zantonelli

    (Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy)

  • Giulia Grazzini

    (Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy)

  • Diletta Cozzi

    (Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy
    Italian Society of Medical and Interventional Radiology (SIRM), SIRM Foundation, 20122 Milan, Italy)

  • Ginevra Danti

    (Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy)

  • Manlio Acquafresca

    (Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy)

  • Vittorio Miele

    (Department of Emergency Radiology, University Hospital Careggi, Largo Brambilla 3, 50134 Florence, Italy)

Abstract

Chest pain is a symptom that can be found in life-threatening conditions such as acute coronary syndrome (ACS). Those patients requiring invasive coronary angiography treatment or surgery should be identified. Often the clinical setting and laboratory tests are not sufficient to rule out a coronary or aortic syndrome. Cardiac radiological imaging has evolved in recent years both in magnetic resonance (MR) and in computed tomography (CT). CT, in particular, due to its temporal and spatial resolution, the quickness of the examination, and the availability of scanners, is suitable for the evaluation of these patients. In particular, the latest-generation CT scanners allow the exclusion of diagnoses such as coronary artery disease and aortic pathology, thereby reducing the patient’s stay in hospital and safely selecting patients by distinguishing those who do not need further treatment from those who will need more- or less-invasive therapies. CT additionally reduces costs by improving long-term patient outcome. The limitations related to patient characteristics and those related to radiation exposure are weakening with the improvement of CT technology.

Suggested Citation

  • Silvia Pradella & Giulia Zantonelli & Giulia Grazzini & Diletta Cozzi & Ginevra Danti & Manlio Acquafresca & Vittorio Miele, 2021. "The Radiologist as a Gatekeeper in Chest Pain," IJERPH, MDPI, vol. 18(12), pages 1-11, June.
    • Handle: RePEc:gam:jijerp:v:18:y:2021:i:12:p:6677-:d:579123
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    References listed on IDEAS

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    1. Corinne Chmiel & Oliver Reich & Andri Signorell & Ryan Tandjung & Thomas Rosemann & Oliver Senn, 2015. "Appropriateness of Diagnostic Coronary Angiography as a Measure of Cardiac Ischemia Testing in Non-Emergency Patients – A Retrospective Cross-Sectional Analysis," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-12, February.
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