Proper evaluation of the patient with acute chest pain is a resource-intensive and expensive process. Critical to the effective management of these patients are the early recognition of a cardiac ischaemic event and the proper placement of the patient in the risk spectrum of the acute coronary syndrome. With increasing economic pressures on health care, physicians, health plans, and medical cen...

* Every day, in various forms, emergency physicians and their patients face the question: how safe is safe enough? Is the risk of something bad low enough that it is reasonable to neglect it [1]? Acute chest pain is a daily challenge and even more so for doctors on cruise ships at sea who face additional questions: is the cause something that can be treated aboard, and if not, what can be done ...

MRA chest and abdomen without IV contrast 7 This procedure is an alternative to CTA for patients with contraindication to both iodinated and gadolinium contrast agents, such as in patients with renal failure, patients with multiple prior chest CTA for similar symptoms, and in patients showing no signs of hemodynamic instability. Scanner availability and local expertise limit widespread use, as ...

Acute chest pain in hypertensive patients presenting to the emergency room constitute a wide spectrum of life threatening conditions including an acute aortic dissection. Acute Aortic syndromes constitute uncommon but lethal identities, with high morbidity and mortality requiring a high index of suspicion, appropriate diagnostic tools and urgent line of management. The authors are reporting a c...

Each year, more than 6 million people in the United States go to emergency departments because of acute chest pain. Some of them have coronary artery disease, but most have diseases that are unrelated to the heart or they have no discernible physiological conditions. The vast majority will undergo various diagnostic tests, and many will be held for observation and may be admitted to the hospita...

A 70-year-old lady presented with retrosternal chest pain and recurrent retching for 4 h. She had history of reflux disease with no prior history of coronary artery disease, hypertension or diabetes. On examination, the patient was in acute distress. Investigations revealed a normal hemogram. ECG showed sinus tachycardia with no ST or T wave changes. Cardiac enzymes were normal. Echocardiograph...

Coronary computed tomographic angiography has become a reliable diagnostic tool in the evaluation of patients with chest pain. Studies have shown this modality to be accurate and safe when compared with conventional methods of assessing patients with chest pain. We review the recent developments with coronary computed tomographic angiography and devote particular attention toward its applicatio...