Chest pain interventions: Difference between revisions

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Revision as of 08:38, 26 December 2021

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Aisha Adigun, B.Sc., M.D.[3]

Common indications of coronary angiography in high risk ACS patients include:

For high-risk patients presented with documented AMI and normal epicardial coronary arteries on CCTA or invasive coronary angiography, or nonobstructive CAD, CMR and echocardiography are useful for evaluation of nonischemic cardiomyopathy or myocarditis.

Among high risk patients, ICA provides a comprehensive assessment of the extent and severity of obstructive CAD.
The determination of the severity of anatomic CAD is critical to guide the use of coronary revascularization. *Approximately 6% to 15% of troponin-positive ACS occurs in the absence of obstructive CAD.
Additional testing may be helpful to determin the strategy of treatment.
Evidence supports that CMR can identify wall motion abnormalities and myocardial edema and distinguish infarct-related scar from non-CAD causes such as myocarditis and nonischemic cardiomyopathy.
Performing CMR within 2 weeks of ACS, can be useful to identify MI with nonobstructive CAD (MINOCA) from other causes.

@@ Line 14: / Line 14: @@
 *::For high-risk [[patients]] presented with documented [[AMI]] and normal [[epicardial coronary arteries]] on [[CCTA]] or invasive [[ coronary angiography]], or  nonobstructive  [[CAD]], [[CMR]]  and  [[echocardiography]] are useful for evaluation of  [[nonischemic  cardiomyopathy]] or [[myocarditis]].
+* Among high risk [[patients]],  [[ICA]]  provides a comprehensive   assessment   of   the   extent and severity of obstructive [[CAD]].
+*The  determination  of  the  severity  of  anatomic  [[CAD]]  is  critical  to  guide  the  use  of  [[coronary  revascularization]]. *Approximately  6%  to  15%  of  [[troponin]]-positive  [[ACS ]] occurs  in  the  absence  of  obstructive  [[CAD]].
+* Additional  testing  may  be  helpful to determin the strategy of treatment.
+*Evidence  supports  that  [[CMR]] can identify [[wall motion abnormalities]] and [[myocardial edema]] and distinguish [[infarct]]-related [[scar]]  from  non-[[CAD]]  causes  such  as  [[myocarditis]] and [[nonischemic cardiomyopathy]].
+*Performing [[CMR]]  within  2  weeks  of  [[ACS]], can  be  useful  to  identify  [[MI ]] with  nonobstructive  [[CAD]]  ([[MINOCA]]) from other causes.
 ==References==