ABSTRACT
Patients presenting with acute chest pain at an emergency department (ED) can pose a difficult diagnostic problem. Diagnostic algorithms in acute chest pain units aim to ‘rule out myocardial infarction’, which requires serial negative electrocardiograms (ECG) and troponin tests. The presence of coronary calcification as assessed by computed tomography (CT) may increase the likelihood that acute chest pain is caused by coronary artery disease. CT coronary angiography can be of use to rule out the presence of myocardial infarction in patients suspected of having an acute coronary syndrome (ACS), combined with negative ECG and biomarker tests at time of admission to the ED. A less timeconsuming, non-invasive diagnostic method that is able to detect or rule out an ACS in patients with acute chest pain of unknown origin would be highly desirable. Refinement of CT technology is necessary to reduce both radiation exposure and artifacts related to patient breathing, coronary motion, and severe coronary calcifications in acute chest pain patients.
