MRA Coronary Arteries Without and With IV Contrast There is no relevant literature to support the use of MRA coronary arteries without and with IV contrast in the initial imaging evaluation of acute nonspecific chest pain with low probability of CAD. MRA Coronary Arteries Without IV Contrast There is no relevant literature to support the use of MRA coronary arteries without IV contrast in the initial imaging evaluation of acute nonspecific chest pain with low probability of CAD. Arteriography Coronary In the acute chest pain setting, invasive coronary angiography is typically undertaken in patients with elevated troponins when there is concern for an acute myocardial infarction/ischemia. There are limited data on its use in the low pretest probability setting of CAD without signs of myocardial ischemia or infarction. Recent studies have proposed triaging of patients for invasive coronary angiography using ischemia stress testing or, alternatively, CCTA coronary anatomy characterization prior to invasive angiography to increase the diagnostic yield [44]. Radiography Ribs and Thoracic Spine Musculoskeletal conditions such as rib fractures can be identified using radiographs, ideally justified by localized pain symptoms. Conditions that may cause thoracic pain such as scoliosis or diffuse idiopathic skeletal hyperostosis are findings that may be detected incidentally on such an examination. There is no relevant literature to support the use of radiographs of the ribs or thoracic spine in the evaluation of acute nonspecific chest pain with low probability of CAD as an initial imaging test. Nuclear Medicine Scan Gallbladder History, physical examination, and subsequent laboratory markers may implicate upper abdomen solid organs as a potential source of nonspecific chest pain. Abdominal ultrasonography is an efficient means of excluding acute cholecystitis as a source of chest pain in the acute setting.
Acute Nonspecific Chest Pain Low Probability of Coronary Artery Disease PCAs. MRA Coronary Arteries Without and With IV Contrast There is no relevant literature to support the use of MRA coronary arteries without and with IV contrast in the initial imaging evaluation of acute nonspecific chest pain with low probability of CAD. MRA Coronary Arteries Without IV Contrast There is no relevant literature to support the use of MRA coronary arteries without IV contrast in the initial imaging evaluation of acute nonspecific chest pain with low probability of CAD. Arteriography Coronary In the acute chest pain setting, invasive coronary angiography is typically undertaken in patients with elevated troponins when there is concern for an acute myocardial infarction/ischemia. There are limited data on its use in the low pretest probability setting of CAD without signs of myocardial ischemia or infarction. Recent studies have proposed triaging of patients for invasive coronary angiography using ischemia stress testing or, alternatively, CCTA coronary anatomy characterization prior to invasive angiography to increase the diagnostic yield [44]. Radiography Ribs and Thoracic Spine Musculoskeletal conditions such as rib fractures can be identified using radiographs, ideally justified by localized pain symptoms. Conditions that may cause thoracic pain such as scoliosis or diffuse idiopathic skeletal hyperostosis are findings that may be detected incidentally on such an examination. There is no relevant literature to support the use of radiographs of the ribs or thoracic spine in the evaluation of acute nonspecific chest pain with low probability of CAD as an initial imaging test. Nuclear Medicine Scan Gallbladder History, physical examination, and subsequent laboratory markers may implicate upper abdomen solid organs as a potential source of nonspecific chest pain. Abdominal ultrasonography is an efficient means of excluding acute cholecystitis as a source of chest pain in the acute setting.