Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain
Abstract Objectives To assess the computed tomography coronary angiography (CTCA) accuracy for demonstrating possible non-cardiovascular causes of non-acute retrosternal chest pain in patients without known coronary artery disease (CAD) and to correlate CTCA results with the patient management and r...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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SpringerOpen
2018-10-01
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| Series: | Insights into Imaging |
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| Online Access: | http://link.springer.com/article/10.1007/s13244-018-0654-x |
| _version_ | 1828399442067193856 |
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| author | Silvia Tresoldi Anna Ravelli Sara Sbaraini Claudia Khouri Chalouhi Francesco Secchi Gianpaolo Cornalba Gianpaolo Carrafiello Francesco Sardanelli |
| author_facet | Silvia Tresoldi Anna Ravelli Sara Sbaraini Claudia Khouri Chalouhi Francesco Secchi Gianpaolo Cornalba Gianpaolo Carrafiello Francesco Sardanelli |
| author_sort | Silvia Tresoldi |
| collection | DOAJ |
| description | Abstract Objectives To assess the computed tomography coronary angiography (CTCA) accuracy for demonstrating possible non-cardiovascular causes of non-acute retrosternal chest pain in patients without known coronary artery disease (CAD) and to correlate CTCA results with the patient management and relief from pain. Methods This prospective observational study was approved by the ethical committee. Consecutive patients suffering non-acute chest pain who underwent CTCA and with not known CAD were enrolled and classified as having coronary diseases (CD) or extracardiac diseases (ECD). Association between age, sex, body mass index (BMI), cardiovascular risk factors, and type of chest pain with CD or ECD was estimated. Correlation between BMI classes and each risk factor was also calculated. Results A total of 106 patients (60 males; age 62 ± 14 years [mean ± standard deviation]; mean BMI 27) were enrolled. Hypertension was found in 71/106 (67%); smoking was significantly more frequent among males (p = 0.003) and hypercholesterolemia among females (p = 0.017); hypertension and hypercholesterolemia significantly correlated with age, and hypertension also with BMI. Pain was atypical in 70/106 (66%) patients. The kind of pain did not correlate with disease or gender. CTCA showed possible causes of chest pain in 69/106 (65%) patients; 32/69 (47%) having only CD, 23/69 (33%) only ECD, and 14/69 (20%) both CD and ECD. Prevalence was: hiatal hernia 35/106 (33%); significant CAD 24/106 (23%); myocardial bridging 22/106 (21%). At follow-up of 94/106 (89%) patients, 71/94 (76%) were pain-free, 14/17 (82%) significant CAD had been treated, and only one patient with non-significant CAD was treated after CTCA. Conclusion CTCA suggested possible causes of non-acute pain in 65% of patients. Main messages • CTCA can either rule in or rule out possible causes of chest pain alternative to CAD. • Clinically relevant findings were detected in 65% of patients with non-acute chest pain. • Non-cardiovascular diseases potentially explained symptoms in 35% of patients. |
| first_indexed | 2024-12-10T09:16:43Z |
| format | Article |
| id | doaj.art-cf25e898bbd143ed8cdc7f2ecd443db2 |
| institution | Directory Open Access Journal |
| issn | 1869-4101 |
| language | English |
| last_indexed | 2024-12-10T09:16:43Z |
| publishDate | 2018-10-01 |
| publisher | SpringerOpen |
| record_format | Article |
| series | Insights into Imaging |
| spelling | doaj.art-cf25e898bbd143ed8cdc7f2ecd443db22022-12-22T01:54:50ZengSpringerOpenInsights into Imaging1869-41012018-10-019568769410.1007/s13244-018-0654-xComputed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest painSilvia Tresoldi0Anna Ravelli1Sara Sbaraini2Claudia Khouri Chalouhi3Francesco Secchi4Gianpaolo Cornalba5Gianpaolo Carrafiello6Francesco Sardanelli7Unit of Diagnostic and Interventional Radiology, Department of Diagnostic Services, ASST Santi Paolo e CarloRadiology, Ospedale dei bambini “Vittore Buzzi”Postgraduation School in Radiodiagnostics, Università degli Studi di MilanoRadiology, Grande Ospedale Metropolitano Niguarda, Piazza dell’Ospedale Maggiore 3Unit of Radiology, Research Hospital Policlinico San DonatoDepartment of Sciences for Health, Università degli Studi di MilanoUnit of Diagnostic and Interventional Radiology, Department of Diagnostic Services, ASST Santi Paolo e CarloUnit of Radiology, Research Hospital Policlinico San DonatoAbstract Objectives To assess the computed tomography coronary angiography (CTCA) accuracy for demonstrating possible non-cardiovascular causes of non-acute retrosternal chest pain in patients without known coronary artery disease (CAD) and to correlate CTCA results with the patient management and relief from pain. Methods This prospective observational study was approved by the ethical committee. Consecutive patients suffering non-acute chest pain who underwent CTCA and with not known CAD were enrolled and classified as having coronary diseases (CD) or extracardiac diseases (ECD). Association between age, sex, body mass index (BMI), cardiovascular risk factors, and type of chest pain with CD or ECD was estimated. Correlation between BMI classes and each risk factor was also calculated. Results A total of 106 patients (60 males; age 62 ± 14 years [mean ± standard deviation]; mean BMI 27) were enrolled. Hypertension was found in 71/106 (67%); smoking was significantly more frequent among males (p = 0.003) and hypercholesterolemia among females (p = 0.017); hypertension and hypercholesterolemia significantly correlated with age, and hypertension also with BMI. Pain was atypical in 70/106 (66%) patients. The kind of pain did not correlate with disease or gender. CTCA showed possible causes of chest pain in 69/106 (65%) patients; 32/69 (47%) having only CD, 23/69 (33%) only ECD, and 14/69 (20%) both CD and ECD. Prevalence was: hiatal hernia 35/106 (33%); significant CAD 24/106 (23%); myocardial bridging 22/106 (21%). At follow-up of 94/106 (89%) patients, 71/94 (76%) were pain-free, 14/17 (82%) significant CAD had been treated, and only one patient with non-significant CAD was treated after CTCA. Conclusion CTCA suggested possible causes of non-acute pain in 65% of patients. Main messages • CTCA can either rule in or rule out possible causes of chest pain alternative to CAD. • Clinically relevant findings were detected in 65% of patients with non-acute chest pain. • Non-cardiovascular diseases potentially explained symptoms in 35% of patients.http://link.springer.com/article/10.1007/s13244-018-0654-xChest painComputed tomography coronary angiographyCoronary artery diseaseDifferential diagnosis |
| spellingShingle | Silvia Tresoldi Anna Ravelli Sara Sbaraini Claudia Khouri Chalouhi Francesco Secchi Gianpaolo Cornalba Gianpaolo Carrafiello Francesco Sardanelli Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain Insights into Imaging Chest pain Computed tomography coronary angiography Coronary artery disease Differential diagnosis |
| title | Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain |
| title_full | Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain |
| title_fullStr | Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain |
| title_full_unstemmed | Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain |
| title_short | Computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non-cardiovascular causes of non-acute retrosternal chest pain |
| title_sort | computed tomography coronary angiography in patients without known coronary artery disease can demonstrate possible non cardiovascular causes of non acute retrosternal chest pain |
| topic | Chest pain Computed tomography coronary angiography Coronary artery disease Differential diagnosis |
| url | http://link.springer.com/article/10.1007/s13244-018-0654-x |
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