chapter  4
14 Pages

Cardiovascular Computed Tomography: A Clinical Perspective

ByMario J Garcia

Coronary artery disease (CAD) is one of the leading causes

of death and disability in the industrialized world. Invasive

coronary angiography is considered the diagnostic standard

for establishing the presence and severity of significant

CAD. However, interventional treatment is generally per-

formed in no more than 50% of diagnostic procedures. As

invasive procedures have an associated mortality (0.15%)

and morbidity (1.5%),1 attention has been turned to finding

accurate noninvasive diagnostic tests. Noninvasive imaging

testing for the detection of CAD has evolved significantly

over the last 50 years. From resting ECG, to stress ECG, and

stress echocardiography and nuclear imaging tests, we have

gradually improved our ability to detect CAD. Stress testing

is useful to establish prognosis in patients with suspected

coronary artery disease but has limited diagnostic utility.2 In

the best circumstances, the accuracy of stress imaging tests is

<85% for the detection of obstructive disease and negligible

for the detection of non-obstructive CAD.