Key result
Triple Rule-out Computed Tomographic Angiography (TRO-CTA) is an efficient single imaging technique in the emergency department to diagnose or exclude acute coronary syndromes, pulmonary embolisms, and acute aortic syndromes.
Why the study?
Does Triple Rule-out Computed Tomographic Angiography (TRO-CTA) improve diagnosis and risk stratification in patients presenting with acute chest pain in the Emergency Department?
Does Triple Rule-out Computed Tomographic Angiography (TRO-CTA) improve diagnosis and risk stratification in patients presenting with acute chest pain in the Emergency Department?
TRO-CTA serves as an efficient single-step imaging technique to diagnose or exclude acute coronary syndromes, pulmonary embolism, and acute aortic syndromes in emergency department patients with acute chest pain.
May support single-modality ED evaluation of acute chest pain; leaves open prospective outcome trials before routine adoption.
BACKGROUND: Acute chest pain is one of the most common reasons for Emergency Department (ED) visits and hospital admissions. As this could represent the first symptom of a lifethreatening condition, urgent identification of the etiology of chest pain is of utmost importance in emergency settings. Such high-risk conditions that can present with acute chest pain in the ED include Acute Coronary Syndromes (ACS), Pulmonary Embolisms (PE) and Acute Aortic Syndromes (AAS). DISCUSSION: The concept of Triple Rule-out Computed Tomographic Angiography (TRO-CTA) for patients presenting with acute chest pain in the ED is based on the use of coronary computed tomographic angiography as a single imaging technique, able to diagnose or exclude three lifethreatening conditions in one single step: ACS, AAS and PE. TRO-CTA protocols have been proved to be efficient in the ED for diagnosis or exclusion of life-threatening conditions and for differentiation between various etiologies of chest pain, and application of the TRO-CTA protocol in the ED for acute chest pain of uncertain etiology has been shown to improve the further clinical evaluation and outcomes of these patients. CONCLUSION: This review aims to summarize the main indications and techniques used in TRO protocols in EDs, and the role of TRO-CTA protocols in risk stratification of patients with acute chest pain.
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Monica et al. (2018) conducted a review in Acute chest pain. Triple Rule-out Computed Tomographic Angiography (TRO-CTA) was evaluated. Triple Rule-out Computed Tomographic Angiography (TRO-CTA) is an efficient single imaging technique in the emergency department to diagnose or exclude acute coronary syndromes, pulmonary embolisms, and acute aortic syndromes.
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