Patrick WI Pau


Multislice computed tomography coronary angiography (CTA) is a noninvasive radiology technique that provides high-resolution images of the coronary artery. It has high sensitivity and specificity for coronary stenosis and can be used to rule out significant coronary artery disease (CAD), thereby avoiding the risk of invasive coronary angiography. There is a danger that CTA may be overused as a screening test for CAD in healthy subjects, thereby exposing the patients to the dangers of adverse reactions to iodinated contrast agents and cancer induction from radiation exposure. Consensus document has been published for clinical guidance on when it is appropriate to order a CTA. Comparative studies with stress nuclear myocardial perfusion imaging (MPI) have shown that significant coronary atherosclerosis demonstrated on CTA may not be associated with ischemia in the same region on MPI. Functional stress testing with exercise or pharmacological agents may be indicated as supplement to CTA for prognostic stratification and assessment for revascularization.