Stress Echocardiography and Heart Computed Tomography (CT) Scan in Emergency Department Patients With Chest Pain

A Randomized Trial Comparing Coronary CT Angiography and Stress Echocardiography for Evaluation of Low-to-Intermediate Risk Emergency Department Chest Pain Patients

The purpose of this study is to determine whether stress echocardiography or computed tomography (CT) of the heart is better at diagnosing emergency room chest pain patients to select appropriate candidates for hospitalization and further work-up.

Inclusion Criteria:

• Presentation to the Emergency Department with chest pain
• Low-to-intermediate risk of coronary disease per Diamond-Forrester criteria
• Free of known coronary artery disease

Exclusion Criteria:

• Inability to undergo both stress echo or coronary CT for any reason
• Contraindication to intravenous iodinated contrast
• Dysrhythmia precluding EKG gating
• Heart rate greater than 60 with contraindication to beta blockers
• Administration of beta blockers within the last 12 hours
• Known severe cardiac valvular disease or pulmonary hypertension
• Stress echocardiography, coronary CT or catheterization within the last 6 months