Patient Selection for Coronary CT Angiography-Video - Patient Selection for Coronary CT Angiography

Video Transcription

Video Summary

In this coronary CT angiography (CTA) education session, Dr. Carol Patrick discusses appropriate patient selection for CTA in stable chest pain cases. Emphasizing shared decision-making, she highlights the use of clinical risk assessment tools and decision pathways, such as HEART and ASCVD risk calculators, to stratify patients by low, intermediate, or high risk. Low-risk patients generally do not require testing, while intermediate/high-risk patients may benefit from CTA or stress testing. Special considerations include older adults, women—who often present atypical symptoms—and culturally sensitive populations. Contraindications for CTA include clinical instability, severe arrhythmias, renal impairment, pregnancy, and inability to cooperate with scan requirements. The session stresses replacing the term "atypical chest pain" with "non-cardiac" chest pain and aligns testing strategies with guideline recommendations. Overall, the focus is on personalized risk assessment to guide appropriate diagnostic testing and management of stable chest pain patients.

Keywords

Coronary CT Angiography

Chest Pain Assessment

Risk Stratification

MACE Score

ASCVD Risk Estimator

Patient Selection Criteria

Stable Chest Pain

Clinical Risk Assessment

HEART Score

Shared Decision-Making