190 - Q&A

Over the past few decades new imaging modalities like cardiac CT, stress CMR and cardiac PET have emerged as well validated tools for the clinical evaluation and diagnosis of chest pain. Like the more established techniques of exercise treadmill testing, SPECT and stress echocardiography these new modalities have their own strengths and limitations. With increasing options the clinician is often left with the dilemma of which test to choose to most effectively diagnose or exclude CAD.

In 2021, the American Heart Association and American College of Cardiology jointly issued substantially updated guidelines on the evaluation and diagnosis of chest pain. Within this, large changes were made in the approach to selecting the most appropriate non-invasive test for evaluating CAD. With choosing the right test for the right patient at the right time now a major priority in Canadian healthcare, these guidelines are potentially useful to help guide clinicians to the most appropriate selection of a non-invasive test in an effort to minimize unnecessary testing. However, it is also necessary to understand how these guidelines are generalizable to Canadian practice, and whether there is strong justification to choose one test over another.

In this workshop we aim to provide attendees a review of this newly published algorithm with a Canadian context in mind. The role of cardiac CT and Nuclear perfusion imaging will specifically be examined, highlighting both strengths and limitations of these modalities in the evaluation of chest pain. Emerging CT and nuclear imaging techniques will also be discussed.