REBEL Cast REBEL Core Cast 111.0 – Cardiac Testing
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Oct 25, 2023 Explore the benefits and limitations of coronary CTN geography as a cardiac test for low-risk chest pain patients. Learn about the importance of selecting appropriate tests based on symptoms and considering limitations. Understand the usefulness of CCTA and nuclear stress tests in assessing heart conditions. Trust your intuition alongside test results.
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CCTA Shows Anatomy, Not Ischemia
- A CCTA is an anatomic study that visualizes coronary artery lumen and plaque burden directly.
- It classifies arteries as normal, non-obstructive, or obstructive but does not prove a lesion causes symptoms.
Ask The Right Question Before Imaging
- Match the test to the patient's symptoms and the clinical question before ordering a CCTA.
- Avoid acting on incidental CCTA findings that don't fit the presenting complaint.
Avoid CCTA If Contrast Or Rhythm Limits Quality
- Avoid CCTA when contrast or high heart rate/rhythm will limit image quality.
- Consider nuclear stress testing for CKD, tachycardia, or atrial fibrillation patients instead.
Take Home Points: A CCTA is an anatomic test to determine if a patient has normal coronary arteries, non-obstructive disease, or obstructive disease. The warranty period for a CCTA is anywhere from 3-10 years depending on the characteristics of the plaque. A nuclear stress test is a functional study that allows for ischemia-driven management. The ...