Non-traumatic Thoracic Emergencies (2022)-R1-CER09-2022

Video Transcription

Video Summary

The speakers at RSNA presented on rapid triage of emergency room patients with acute chest pain using coronary CT, acute aortic syndromes, and pulmonary embolism (PE). The role of coronary CT in diagnosing and excluding acute coronary syndrome is now validated by recent guidelines, emphasizing quick and accurate assessment of patients with chest pain. Cardiac CT offers a high level of evidence-based recommendation, aiding in the reduction of discharge time and ensuring appropriate resource use, while also highlighting the importance of functional information like CTFFR for specific ischemia diagnosis.<br /><br />In acute aortic syndromes, including aortic dissection, intramural hematoma (IMH), and penetrating atherosclerotic ulcers (PAU), CT imaging helps identify the common presentation of chest or back pain due to media disruption. Imaging protocols include non-contrast and contrast-enhanced CT scans, essential for accurate diagnosis and management. The lecture also discussed the importance of recognizing non-contrast CT findings and differentiating between normal pathology and surgical complications.<br /><br />The session on pulmonary embolism in the acute setting focused on the diagnostic power of multi-detector CTA, stratification based on risk and PE location (e.g., sub-segmental). Prognostic imaging factors like the RV/LV ratio and IVC reflux are crucial for evaluating right heart dysfunction, while the nuances of managing incidental PE and mimickers, such as air or fat embolisms, were also discussed. The importance of comprehensive imaging evaluation and clinical context, along with advanced tools, for enhancing patient outcomes in emergency situations was emphasized.

Keywords

coronary CT

acute chest pain

aortic syndromes

pulmonary embolism

cardiac CT

CT imaging

multi-detector CTA

emergency triage

diagnostic protocols

imaging evaluation