Chest Pain Guidelines

The first comprehensive guideline for the evaluation of chest pain was published in October 2021 by the American Heart Association (AHA) and the American College of Cardiology (ACC) and received the endorsement of most of the other U.S. subspecialty cardiology societies. The new guideline recommends medical professionals use standardized risk assessments, clinical pathways and tools to evaluate and communicate with people experiencing chest pain. While the guideline covers the role of all types of tests and imaging, the new guidelines elevated the frontline use of coronary computed tomography angiography (CCTA) and FFR-CT in specific patients. This inclusion has caused a large amount of interest in expanding cardiac CT programs.

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Cardiac CT comparable to invasive angiography when assessing stable chest pain, new meta-analysis confirms

Researchers examined data from nearly 5,400 patients, tracking such outcomes as myocardial infarction, stroke and all-cause mortality. 

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ACC, AHA work to standardize the way cardiologists and their colleagues talk about chest pain

The American College of Cardiology and American Heart Association have collaborated on a new update to the much-discussed 2021 chest pain guidelines. The American College of Emergency Physicians and Society for Cardiac Angiography and Interventions also contributed to the document.

CCTA a helpful tool for interventional cardiologists planning coronary procedures

A new consensus statement from the Society of Cardiovascular Computed Tomography emphasized the increasing importance of CCTA among interventional cardiologists. It is no longer seen as “a mere diagnostic tool," the group observed. 

Cardiac CT now in the spotlight thanks to chest pain guidelines

With the elevation of cardiac CT to a 1A indication in the 2021 Chest Pain Guidelines, there has been a large amount of interest in starting coronary artery CT angiography (CCTA) programs. 

Ron Blankstein, MD, MSCCT, associate director, cardiovascular imaging program, director, cardiac computed tomography, Brigham and Women's Hospital, and professor of medicine, Harvard Medical School, was a co-author on the ACC 2021 Chest Pain Guidelines,[1] which now lists coronary computed tomography angiography (CCTA or CTA) as a 1A level recommendation for front line imaging. He gave an overview of the guidelines during the 2022 Society of Cardiovascular CT (SCCT) meeting in July. #SCCT2022

VIDEO: The role of cardiac CT in the 2021 chest pain guidelines

Ron Blankstein, MD, associate director of the cardiovascular imaging program and director of the cardiac computed tomography program for Brigham and Women's Hospital, was a co-author on the ACC 2021 Chest Pain Guidelines, which now lists coronary computed tomography angiography (CCTA or CTA) as a 1A level recommendation for frontline imaging. 

Examples of new cardiac CT technologies at the 2022 SCCT meeting. Top left clockwise, realistic 3D rendering inside the heart, the GE Revolution Apex scanner, Cleerly's AI automated soft plaque assessment, and CT strain imaging from Medis. #SCCT #SCCT2022 #YesCCT #CTA #CCTA, new computed tomography technology

PHOTO GALLERY: Cardiac CT advances at SCCT 2022

View a variety of images from the 2022 Society of Cardiovascular Computed Tomography (SCCT) meeting in Las Vegas.

Example of a patient's coronary tree extracted from a cardiac CT scan. CT allows very detailed anatomical imaging and now physiological and plaque information that can be useful in pre-planning interventional procedures. Imaging from the GE Revolution Apex system at SCCT 2022.

VIDEO: CT imaging to plan coronary interventions — Interview with Jonathon Leipsic, MD

Jonathon Leipsic, MD, chairman of the Department of Radiology, University of British Columbia, explains how noninvasive computed tomography angiography (CTA) can be used to aid in planning interventional cardiology procedures for percutaneous coronary intervention (PCI) and chronic total occlusions (CTO). 

Left, coronary CT angiography of a vessel showing plaque heavy calcium burden. Right, image showing color code of various types of plaque morphology showing the complexity of these lesions. The right image was processed using the FDA cleared, AI-enabled plaque assessment from Elucid.

Cardiac CT soft plaque assessment may offer paradigm shift for coronary disease screening

New artificial intelligence software that can evaluate coronary CT scans to automatically assess soft plaques were by far the biggest technology advance discussed at the Society of Cardiovascular Computed Tomography (SCCT) 2022 meeting. 

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