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CCTA for severe Chest pain in ED: Total Guide





The first thought a person might have while experiencing chest pain is that maybe it is a heart attack. Although chest pain is a common and widely-experienced sign of a heart attack, it can also be induced by many other conditions that might not be serious. In any case of severe chest pain, a person is advised to visit the hospital immediately. The doctors might then undertake procedures that will help them diagnose the causes of the chest pain. One such crucial diagnostic technique is a coronary computed tomography angiogram (CCTA) performed to observe and capture images of the blood vessels and tissues. If the chest pain is heart-related, this procedure will pinpoint the areas of plaque development or injuries.


Chest pain:


Over the years, it has been observed that chest pain is one of the leading reasons people visit the emergency room (ER). Chest pain varies depending on the intensity, duration, location, etc. A dull ache to a sharp piercing ache might have their own underlying causes. It may indicate a serious heart-related problem or a common gastrointestinal problem or muscle pain. A study showed that only 5.5% of all chest pain-related ER visits result in a diagnosis of a life-threatening heart-related problem.


What causes chest pain:


Chest pain can be caused by various reasons, such as:

  • Heart-related causes of chest pain:

Most heart-related causes are serious and require immediate attention. Depending on the condition, patients might experience severe to acute chest pain that lingers for a long time or frequently recurs. Some causes are heart attack, angina, pericarditis, myocarditis, cardiomyopathy, and aortic dissection.

  • Gastrointestinal causes of chest pain

Gastrointestinal causes can also lead to chest pain. A sharp pain in the lower chest area may be caused due to acid reflux, heartburn, oesophageal disorders, gallstones, and inflammation of the gallbladder or pancreas.

  • Lung-related causes of chest pain

Chest pain caused by lung-related issues might be due to pneumonia, viral bronchitis, pneumothorax (collapsed lung), a blood clot or pulmonary embolus, or bronchospasm commonly occurring in people with asthma and related disorders such as chronic obstructive pulmonary disease (COPD).

  • Muscle- or bone-related causes of chest pain

The causes of chest pain related to the muscles or bones are: bruised or broken ribs, sore muscles from exertion or chronic pain syndromes, compression fractures causing pressure on a nerve

  • Other causes

Shingles and panic attacks can also cause chest pain.


What is CCTA?


The coronary computed tomography angiogram scanner looks like a large, doughnut-shaped machine with a short tunnel in the centre. The patient is made to lie on a table that moves inside the tunnel. The x-ray tube and electronic x-ray detectors are located opposite each other in a gantry ring, which rotates around the patient. The computer then processes the imaging information in a separate control room where the technician operates the scanner and monitors the process directly. The technologist and the patient can talk and hear each other to you using a speaker and microphone.

A coronary CT is very similar to a normal CT scan. The differences are that CCTA uses a heart monitor to determine the heart rate and has a faster speed than the CT scanner. CCTA utilizes an injection of iodine-containing contrast material and CT scanning to study the arteries and blood vessels responsible for blood supply to the heart and determine whether they have narrowed down. Then the technician takes a specialized X-ray CT scan to analyse the highlighted areas.


What are some common uses of the procedure?


The most common reason your healthcare provider might advise you to get a CT angiogram is when you get chest pain. This is done to examine whether your coronary arteries are narrowed or blocked. But certain other issues to diagnose which your healthcare provider may use a CT angiogram are:

  1. An aneurysm is a condition where irregular bulges or widening of blood vessels is observed.
  2. To detect atherosclerosis, a condition of narrowed blood vessels due to the build-up of fatty plaques.
  3. To determine the risk of coronary artery disease in patients who experience chest pain and those with normal, non-diagnostic, and unclear ECG results.
  4. Determine low to intermediate risk regarding atypical chest pain in the emergency department.
  5. Causes of non-acute chest pain.
  6. Identify abnormal anatomy of the coronary arteries
  7. Detection of other possible causes of chest pain symptoms, such as a collapsed lung, pulmonary embolism or blood clot in the vessels leading to the lungs, or aortic abnormalities.


Dr. Ganesh Seth
Cardiac Care
Meet The Doctor
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