Khawaja Ehtesham Ahmad, Irfan Majeed, Muhammad Ayaz.
Role of CT Coronary angiography for early triage of patient presenting with chest pain in the Emergency Department.
J Cardiovascular Dis Jan ;13(3):77-80.

ABSTRACT: OBJECTIVE: To study role of CT coronary angiography for early triage of patient presenting with chest pain in the emergency department of a tertiary care teaching hospital. MATERIAL AND METHODS: This descriptive cross sectional study was conducted at the department of cardiac imaging, Punjab Institute of Cardiology, Lahore from 1st January 2013 to 30th June 2013. A total of 120 patients fulfilling inclusion and exclusion criteria were included from department of emergency after taking informed consent. Detailed history including risk factors was taken and physical examination was performed. Patients fulfilling inclusion criteria were undergone 64 slices MDCT coronary angiography. Result:A total 120 consecutive patients with typical acute chest pain and normal electrocardiogram and normal cardiac enzymes were included in the study. Mean age of male (n=91) (75.8%) was 47.82 ± 9.10 and that of female (n=29) (24.2 % of total) was 48.10 ± 8.52). Out of 29 female only 3(10.34%) have coronary artery disease and that of male 14 (15.35%) had coronary artery disease. Regarding coronary artery disease related four major risk factors, 48 (40.0%) had hypertension. Out of these 48 only 6(12.5%) had coronary artery disease. The family history for ischemic heart disease was positive in 41(34.2%) patient and 7(17%) had coronary artery disease. 58(48.3) patients were smoker and among them 11(19%) had coronary artery disease. 46 (38.3) were diabetic and only 5(10.9%) had coronary artery disease. Among 120 patients subjected to computed tomography 17 (14.2%) had coronary artery disease. 5(29.4%), 6(35.3%) and 5(29.4%) had single vessel, double vessel and triple vessel disease respectively. Out of 17 coronary artery disease left main stem disease was mild/normal in 12 (70.6%), moderate 3(17.6%) and severe in 2(11.8%). CONCLUSION: In view of huge burden of patients coming to emergency department and the patients need time consuming process of serial ECG and cardiac enzymes. By doing early CT we can confidently triage patients and thus decrease burden of patients in emergency department. KEYWORDS: Coronary artery disease, Coronary angiography, Multi-detector computed tomography

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