CT-coronarography - ruleout MI

Prof. Dr. Udo Hoffmann is a clinically active cardiac radiologist with >10 years of expertise and one of the pioneers of cardiac CT imaging. He currently is an Associate Prof. of Radiology, Harvard Medical School, Boston, MA and Director of the MGH Cardiac MR PET CT Program, a collaborative effort between the Department of Radiology and the Division of Cardiology at the Massachusetts General Hospital, Boston, MA as well as the Cardiovascular Core Lab at MGH. He is also Prof. of Radiology at the General Hospital and University in Vienna, Austria. Dr. Hoffmann received his medical degree from the University of Leipzig in Germany, completed an internship in the department of cardiology and a residency in the department of radiology at Vienna General Hospital, University of Vienna, Austria aswell as two year fellowship in cardiovascular imaging at the Department of Radiology at MGH. In 2006 he graduatedas a Master of Public Health in Clinical Effectiveness from the Harvard Public School Health, Boston. He has received multimillion dollar research awards from the National Instituteof Health. His research has resulted in more than 150 original research publications, reviews and book chapters. Dr. Hoffmann is Chair of the Imaging Oversight Committee of the Framingham Heart Study.

Patients with acute chest pain, normal biomarkers, and normal or non-diagnostic electrocardiograms (ECGs) represent a cohort of patients who are diagnostically challenging and managed inefficiently. Because diagnostic testing that would typically allow physicians to ruleout the occurrence of myocardial ischemia (e.g. nuclear imaging, echocardiography, and exercisetreadmill ECG) is NOT available for the initial emergency department (ED) evaluation, most of these patients are hospitalized for 24 to 36 hours to exclude the presence of acute coronary syndrome (ACS). Newest cardiac computed tomography (CT) technology accurately detects coronary atherosclerotic plaque and stenosis, and also permits the assessment of global and regional left ventricle (LV) function. Blinded observational studies demonstrate that absence of coronary atherosclerotic plaque by cardiac CT is a powerful predictor of the absence of ACS (negative predictive value: 100%) and can be detected in a significant fraction of subjects with acute chest pain (up to 50%). Thus, the implementation of cardiacCT in the early ED triage process may enable immediate and safe discharge of a significant fraction of patients, all of whom are currently admitted unnecessarily.