CAN COMPUTERIZED TOMOGRAPHIC ANGIOGRAPHY BE USED TO TRIAGE PATIENTS WITH CHEST PAIN PRESENTING TO THE EMERGENCY DEPARTMENT?

Objective: To confirm the findings of Computerized Tomography Angiography by invasive angiography.Methodology: This comparative study on 50 patients fulfilling the inclusion criteria were admitted incardiology ward. Then they were shifted to catheterization lab of Lady Reading Hospital Peshawar forinvasive angiography and segmental analysis of all four vessels i.e. right coronary, left coronarycircumflex and left anterior descending artery was done.Results: A total of 50 patients were studied both with CT angio and invasive angio and 750 segments wereanalyzed for the 4 main arteries that is LMS, LAD, RCA and Circumflex. The sensitivity of CT angiographyfor the LMS was 87.5%, Specificity 100%, PPV 100% and NPV 97.6%, PPV was 100% and NPV was also100%. Similarly the diagnostic accuracy of CT angiography for the circumflex was sensitivity 100%,PPV100% and NPV 97.91 to 100%. For RCA the sensitivity was from 60 to 100%, specificity 100%, PPV 100%and NPV 95 to 100%.Conclusion: Coronary CT angio with the highest resolution scanners could be a suitable means for rapidtriage of patients presenting to emergency departments with chest pain and for evaluation of patients withequivocal stress test results who might otherwise need invasive angiography.