Is computed tomography coronary angiography the most accurate and effective noninvasive imaging tool to evaluate patients with acute chest pain in the emergency department?: CT coronary angiography is the most accurate and effective noninvasive imaging tool for evaluating patients presenting with chest pain to the emergency department.

Patients with acute chest pain (ACP) represent a global health and economical challenge for the US healthcare system. The more than 8 million annual emergency department (ED) visits impart a significant economic burden in excess of $8 billion annually,1–3 particularly as 80% of these patients are admitted to the hospital and subsequently undergo extensive testing for what often turns out to be noncardiac chest pain. However, 2% to 8% of discharged patients inadvertently have acute coronary syndrome (ACS),4–7 which accounted for 26% of all money paid in closed malpractice claims in emergency medicine from 1985 to 2003.8,9