News

Harold I. Litt

Estimates are that of the over six million patients who present each year at U.S. emergency departments (ED) with chest pain, less than 20 percent are actually having a cardiac incident, resulting in a total cost of US$8 billion per year. The doctors are working to initiate multisite studies that will change immediate medical response to patients presenting with chest pain, and create a new gold standard for ED cardiac diagnosis with Dual Source computed tomography (CT) that will save money and time, at the same time providing quicker and better care for patients.

Harold I. Litt, MD, PhD, Chief of Cardiovascular Imaging Section, Department of Radiology, University of Pennsylvania Health System, Philadelphia, Pennsylvania; Udo Hoffmann, MD, Director of Radiology, Massachusetts General Hospital, Boston, Massachusetts; and Gilbert Raff, MD, Director of the Ministrelli Center for Advanced Cardiovascular Imaging at William Beaumont Hospital, Royal Oak, Michigan, recently discussed how their emerging research suggests that CT scanning as a triage method for patients presenting to the ED with chest pain can save lives, money, and time.

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Udo Hoffmann

CT improves workflow, treatment

Instead of catheter angiography, enzyme studies, and stress tests that can require a long stay in the ED, the immediate CT scan protocol can create a scenario where door-to-balloon time for ill patients can be 90 minutes, and the total time in the hospital for patients with negative results is reduced from an average 22 to 25 hours to a few hours. The doctors referenced are working on independent studies at major urban hospitals to show that using CT angiography at intake can rapidly, accurately, and cost-effectively identify which patients are at risk and need treatment and can allow the majority of patients to return home safely with low risk for a recurrent problem. Based on randomized large-scale trials, the physicians believe that CT scan in the ED allows for improved workflow, better treatment for cardiac patients at risk, and the ability to get detailed images of vessels and plaque in obese patients and patients who cannot be given beta-blockers to slow the heart down.

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Gilbert Raff

No need for beta-blocker saves additional time

Siemens Dual Source CT Technology, with its heart rate independent temporal resolution of up to 75 milliseconds (with SOMATOM^®Definition Flash) also provides the opportunity to not use beta-blockers to lower the patients heart rate. Many clinical trials have shown that beta-blockers are optional and that this can save important time for beta-blocker administration and aftercare in an acute care setting.

Key Benefits

Key benefits of CT as triage tool for chest pain patients:

Significant reduction of patient time and cost of care
Ability to let patients visualize results of their CT scans and make life-saving lifestyle changes