So some interesting contradictions in the latest round of “throwaway journals” about the utility of CT angiogram for evaluating chest pain. Emergency Physicians Monthly notes that CT angiogram is just “not ready for primetime” while EM news has a banner headline reading “CT Angiography in the ED: Safe and Cost Effective.”

EP Monthly - CT Angio not ready for primetime (http://www.epmonthly.com/index.php?option=com_content&task=view&id=337&Itemid=28&limit=1&limitstart=1)

EM News - CT Angio: Safe and Effective (http://www.em-news.com/pt/re/emmednews/fulltext.00132981-200809000-00001.htm;jsessionid=LQkHBGpkF3L1TQkGB9qqZhhGphdyl wlQ5qh8tq80GCQ8y7FlnbLn!612563345!181195628!8091!-1)

So where are we in terms of what we should be doing and what we are doing?

I'm falling some where in between. I really haven't started using CT cardiac angiograms. I know that they are pretty good for detecting tight lesions. Some of my colleagues are starting to consider them as we can move some of our chest pain patients faster if we don't have to rely on cardiology for their eval and stress testing.

That being said, I know what a stress test means, in terms of outcome. I'm not yet sure I know what a positive or a negative CT angio means.

I guess that if you add in the mSv, you have to weigh in the LNT model for radiation risks as well (see other thread).
T