Journal of thoracic imaging
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The evaluation of patients presenting with chest pain to the emergency department remains a significant challenge. The primary goal is to distinguish clinically insignificant etiologies from life-threatening causes such as myocardial ischemia, aortic dissection, and pulmonary embolism. The conventional evaluation consisting of history, electrocardiography, and biochemical markers is often inconclusive and noninvasive imaging techniques may prove valuable. This article describes some of the available options and focuses on the potential role of CT angiography to assess indeterminate chest pain.
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With the latest generations of multidetector row computed tomography (CT) scanners, CT of the heart is about to fulfill its promise to become the premier noninvasive imaging modality for the cardiac assessment. The performance of this modality has been continuously improved to a point where CT, beyond mere feasibility studies, is firmly establishing its role in the diagnostic work-up of patients with suspected cardiac disease. This has been enabled by ongoing technical refinements, which are the topic of this contribution. This review traces the evolution of CT for cardiac applications, describes the current status of scanner technology with special emphasis on dual-source CT, and provides insights into potential future developments for further refinement of this technique.