Ever since CDUH (Cebu Doctors' University Hospital) got it's first GE 64-slice CT, a lot of queries arose about the usefulness of this machine in the evaluation of coronary artery disease. Indeed it is revolutionary in the sense that we can now have a noninvasive tool to evaluate out patient acutely with less time delay once they get admitted with chest pains from the ER. Here are some of the facts:
1. It is a good screening tool for coronary artery disease (CAD) by detecting coronary calcium score. Calcium scoring is used as a surrogate marker for CAD. It is good but just like anything else in life we live with statistical data and probabilities hence, it is never to be considered fool proof.
2. Multislice CT angiography, is a diagnostic tool for the evaluation of the vasculature including the coronary ciculation, pulmonary, renal, peripheral vasculature and many more. I reserve this test to patients who are adverse to doing the invasive coronary angiography.
3. This test is not for all, there are limitations to each and every test including, the presence or absence of renal insufficiency, cardiac arrhythmias, degree of coronary calcification and the like. The best way is to consult your own physician regarding the appropriateness of such test in your case.
4. Patients with documented or a highly probable CAD (prior MI, strongly positive stresstest) need not take this test. It is preferable to go ahead and proceed with the invasive angiography because this is not only a diagnostic but also an avenue for therapeutic intervention (Angioplasty). CT angiogram is purely a diagnostic test only.
5. MSCT is a good and excellent diagnostic tool we have for the evaluation of acute chest pains in the ER because CT personnel in the hospital are almost always ready 24/7.
