Other cardiovascular entities, such as aortic aneurysms, aortic dissections, and pulmonary embolism, may be suggested from the chest radiography but with far lower sensitivity than other imaging modalities such as multidetector CT. Noncardiac findings associated with chest pain that can be identified on the chest radiograph include pneumothorax, fractured ribs, pleural effusions, and pneumonia, among others. CTA Coronary Arteries There is no relevant literature regarding the use of CCTA in the evaluation of ACS in high-probability patients. CT Chest CT Chest Nongated chest CT, although useful for evaluating noncardiac thoracic pathology, does not currently have a role in the evaluation of possible ACS, although perfusion defects can be seen on nongated chest CT in patients with ACS [101,102]. CTA Chest CTA of the chest has a well-established role for evaluating other etiologies that may mimic ACS, such as aortic dissection, acute pericarditis, pneumonia, and pneumothorax [27,103]. CT Coronary Calcium There is no relevant literature regarding the use of CT calcium scoring in the evaluation of ACS in high-probability patients. MRA Coronary Arteries There is no relevant literature regarding the use of coronary MRA in the evaluation of ACS in high-risk patients. MRI Heart Function and Morphology The use of T2-weighted CMR to identify myocardial edema can help predict outcomes in patients with NSTE-ACS, without impacting time to catheterization, and a combination of noncontrast and postcontrast resting CMR sequences can help inform prognosis and identify myocardial areas at risk [125,144]. In addition, CMR has a role in elucidating the cause of myocardial necrosis in patients with elevated cardiac biomarkers presumed to have ACS but with nonobstructive coronary arteries by CT or catheter angiography [126-128,145].
Chest Pain Possible Acute Coronary Syndrome PCAs. Other cardiovascular entities, such as aortic aneurysms, aortic dissections, and pulmonary embolism, may be suggested from the chest radiography but with far lower sensitivity than other imaging modalities such as multidetector CT. Noncardiac findings associated with chest pain that can be identified on the chest radiograph include pneumothorax, fractured ribs, pleural effusions, and pneumonia, among others. CTA Coronary Arteries There is no relevant literature regarding the use of CCTA in the evaluation of ACS in high-probability patients. CT Chest CT Chest Nongated chest CT, although useful for evaluating noncardiac thoracic pathology, does not currently have a role in the evaluation of possible ACS, although perfusion defects can be seen on nongated chest CT in patients with ACS [101,102]. CTA Chest CTA of the chest has a well-established role for evaluating other etiologies that may mimic ACS, such as aortic dissection, acute pericarditis, pneumonia, and pneumothorax [27,103]. CT Coronary Calcium There is no relevant literature regarding the use of CT calcium scoring in the evaluation of ACS in high-probability patients. MRA Coronary Arteries There is no relevant literature regarding the use of coronary MRA in the evaluation of ACS in high-risk patients. MRI Heart Function and Morphology The use of T2-weighted CMR to identify myocardial edema can help predict outcomes in patients with NSTE-ACS, without impacting time to catheterization, and a combination of noncontrast and postcontrast resting CMR sequences can help inform prognosis and identify myocardial areas at risk [125,144]. In addition, CMR has a role in elucidating the cause of myocardial necrosis in patients with elevated cardiac biomarkers presumed to have ACS but with nonobstructive coronary arteries by CT or catheter angiography [126-128,145].