Chest Pain Guidelines

The first comprehensive guideline for the evaluation of chest pain was published in October 2021 by the American Heart Association (AHA) and the American College of Cardiology (ACC) and received the endorsement of most of the other U.S. subspecialty cardiology societies. The new guideline recommends medical professionals use standardized risk assessments, clinical pathways and tools to evaluate and communicate with people experiencing chest pain. While the guideline covers the role of all types of tests and imaging, the new guidelines elevated the frontline use of coronary computed tomography angiography (CCTA) and FFR-CT in specific patients. This inclusion has caused a large amount of interest in expanding cardiac CT programs.

Left, HeartFlow's RoadMap analysis enables cardiac CT readers to identify stenoses in the major coronary arteries. The AI provides visualization and quantification of the location and severity of anatomic narrowings. Right image, HeartFlow's Plaque Analysis AI algorithm automates assessment of coronary plaque characteristics and volume on CCTA exams to greatly reduce the time it takes to manually assess and quantify these features.

HeartFlow gains FDA clearance for 2 new AI-powered imaging assessments

The solutions, Plaque Analysis and RoadMap Analysis, both use coronary CT angiography to provide clinicians with a noninvasive look at patients who present with coronary artery disease and face a heightened myocardial infarction risk.

October 18, 2022
Coronary CT Angiography (CCTA) has evolved into a much more helpful resource than interventional cardiologists may have originally believed. In fact, the Society of Cardiovascular Computed Tomography (SCCT) emphasized in a new expert consensus statement that CCTA provides specialists with an effective tool in the preparation and optimization of coronary procedures. The 2021 chest pain guidelines elevated CTA to a class 1A recommendation. Harold Litt , MD, explains the use of CCTA in the ED.

VIDEO: Cardiac CT as a front-line chest pain exam in the ED

Harold Litt, MD, explains the use of cardiac CT as a primary imaging exam for chest pain at his emergency department over the past decade.

October 13, 2022

New recommendations highlight the importance of CCTA when treating acute chest pain in the ED

The Society of Cardiovascular Computed Tomography developed and published the new document to help educate healthcare providers who regularly treat acute chest pain in the emergency department. 

September 29, 2022
Coronary CT Angiography (CCTA) has evolved into a much more helpful resource than interventional cardiologists may have originally believed. In fact, the Society of Cardiovascular Computed Tomography (SCCT) emphasized in a new expert consensus statement that CCTA provides specialists with an effective tool in the preparation and optimization of coronary procedures. The 2021 chest pain guidelines elevated CTA to a class 1A recommendation. Harold Litt , MD, explains the use of CCTA in the ED.

CCTA a helpful tool for interventional cardiologists planning coronary procedures

A new consensus statement from the Society of Cardiovascular Computed Tomography emphasized the increasing importance of CCTA among interventional cardiologists. It is no longer seen as “a mere diagnostic tool," the group observed. 

August 30, 2022
A cardiac CT scan being performed at Duly Healthcare in suburban Chicago in the spring of 2022. This is one of the first outpatient cardiology clinics in the U.S. to implement a CCTA program for screening non-acute chest pain patients and for structural heart evaluations. This applies to CCTA, CTA, Cardiac CT, and CT angiography and coronary CT angiography.

Cardiac CT now in the spotlight thanks to chest pain guidelines

With the elevation of cardiac CT to a 1A indication in the 2021 Chest Pain Guidelines, there has been a large amount of interest in starting coronary artery CT angiography (CCTA) programs. 

August 3, 2022
Ron Blankstein, MD, MSCCT, associate director, cardiovascular imaging program, director, cardiac computed tomography, Brigham and Women's Hospital, and professor of medicine, Harvard Medical School, was a co-author on the ACC 2021 Chest Pain Guidelines,[1] which now lists coronary computed tomography angiography (CCTA or CTA) as a 1A level recommendation for front line imaging. He gave an overview of the guidelines during the 2022 Society of Cardiovascular CT (SCCT) meeting in July. #SCCT2022

VIDEO: The role of cardiac CT in the 2021 chest pain guidelines

Ron Blankstein, MD, associate director of the cardiovascular imaging program and director of the cardiac computed tomography program for Brigham and Women's Hospital, was a co-author on the ACC 2021 Chest Pain Guidelines, which now lists coronary computed tomography angiography (CCTA or CTA) as a 1A level recommendation for frontline imaging. 

July 28, 2022
Examples of new cardiac CT technologies at the 2022 SCCT meeting. Top left clockwise, realistic 3D rendering inside the heart, the GE Revolution Apex scanner, Cleerly's AI automated soft plaque assessment, and CT strain imaging from Medis. #SCCT #SCCT2022 #YesCCT #CTA #CCTA, new computed tomography technology

PHOTO GALLERY: Cardiac CT advances at SCCT 2022

View a variety of images from the 2022 Society of Cardiovascular Computed Tomography (SCCT) meeting in Las Vegas.

July 25, 2022
Left, coronary CT angiography of a vessel showing plaque heavy calcium burden. Right, image showing color code of various types of plaque morphology showing the complexity of these lesions. The right image was processed using the FDA cleared, AI-enabled plaque assessment from Elucid.

Cardiac CT soft plaque assessment may offer paradigm shift for coronary disease screening

New artificial intelligence software that can evaluate coronary CT scans to automatically assess soft plaques were by far the biggest technology advance discussed at the Society of Cardiovascular Computed Tomography (SCCT) 2022 meeting. 

July 20, 2022

Around the web

Automated AI-generated measurements combined with annotated CT images can improve treatment planning and help referring physicians and patients better understand their disease, explained Sarah Jane Rinehart, MD, director of cardiac imaging with Charleston Area Medical Center.

Two advanced algorithms—one for CAC scores and another for segmenting cardiac chamber volumes—outperformed radiologists when assessing low-dose chest CT scans. 

"Gen AI can help tackle repetitive tasks and provide insights into massive datasets, saving valuable time," Thomas Kurian, CEO of Google Cloud, said Tuesday. 

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