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Acute Coronary Syndrome - Rule-Out Protocol

ML Nedevska


BACKGROUND: Acute chest pain is a common diagnostic dilemma in the Emergency Department. Patients with acute coronary syndrome often present with atypical chest pain complaints, unremarkable findings on physical examination, and an ECG that is either difficult to interpret or has normalized at presentation.

MAIN BODY: Optimal diagnostic modality to identify patients with acute coronary syndrome in emergency settings should be quick, noninvasive, cost-effective and readily available.

Coronary computed tomography, coronary angiography can provide high-quality images of the heart and coronary vasculature. Coronary CTA provides accurate information about the degree of stenosis as well as certain characteristics of plaque, associated with a higher risk of future ACS. Additionally, coronary CTA allows evaluation of important noncoronary cardiac findings- such as acute aortic syndrome and pulmonary embolism.

CONCLUSION: Cardiac computed tomography is a very useful diagnostic modality in selected patients with acute chest pain in emergency settings.


acute chest pain, acute coronary syndrome, cardiac computed

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ML Nedevska

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