Opportunities and Challenges of Computed Tomography Coronary Angiography in the Investigation of Chest Pain in the Emergency Department—A Narrative Review

Manuja Premaratne, Gloria Patricia Garcia, William Thomas, Shaiq Hameed, Ashley Leadbeatter, Nay Htun, Girish Dwivedi, David M. Kaye

Research output: Contribution to journalReview ArticleResearchpeer-review

1 Citation (Scopus)


Chest pain is one of the most common presentations to emergency departments. However, only 5.1% will be diagnosed with an acute coronary syndrome, representing considerable time and expense in the diagnosis and investigation of the patients eventually found not to be suffering from an acute coronary syndrome. PubMed and Medline databases were searched with variations of the terms “chest pain”, “emergency department”, “computed tomography coronary angiography”. After review, 52 articles were included. Computed tomography coronary angiography (CTCA) is a class I endorsement for investigating chest pain in major international societal guidelines. CTCA offers excellent sensitivity and negative predictive value in identifying patients with coronary disease, with prognostic data impacting patient management. If CTCA is to be applied to all comers, it is pertinent to discuss the advantages and potential pitfalls if use in the Australian system is to be increased.

Original languageEnglish
Pages (from-to)307-314
Number of pages8
JournalHeart Lung and Circulation
Issue number3
Publication statusPublished - Mar 2023
Externally publishedYes


  • Acute coronary syndrome
  • Computed tomography coronary angiography

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