CTA in the evaluation of acute chest pain syndromes. Should more widespread use be advocated?

Introduction: With the advent of CT more than 3 decades ago, we have seen rapid evolution of this technology, so that we are now able to noninvasively accurately image the coronary arterial tree. This has opened up a debate as to the role of this imaging modality in our day-to-day evaluation of acute coronary syndromes. Much recent literature has focused on whether in the acute setting this modality should be incorporated into current evaluation and treatment guidelines.

Areas covered: A comprehensive review of a literature illustrating the utility of CTA in the acute care setting is presented. The paper goes on to address the benefits and challenges of implementation of CTA in the evaluation of acute chest pain syndromes. Alternative guidelines and insights on future directions are presented.

Expert opinion: In this current era where CAD, and more specifically acute chest pain syndromes, remains as a large part of ED visits and also healthcare costs, CTA will play an important role in the diagnosis and treatment of individuals. It remains only a matter of time when this will be implemented in our guidelines, in light of the recent literature and ever improving CTA protocols.