ProspEctive First Evaluation in Chest Pain Trial

ProspEctive Randomized First Evaluation in Chest Pain Trial

The purpose of this study is to determine the best initial test in patients admitted to the hospital complaining of chest pain.

Currently, physicians can either choose a stress test or a CT scan of the heart to evaluate patients admitted with with chest pain. Very little is known about which test provides the best information to physicians, positively impacts patients medical care, and decreases future hospital admissions and testing. To study this the investigators are randomizing patients admitted to our hospital with chest pain to a stress test or coronary CT angiography. The investigators will then follow these patients for a 2 year period.

Inclusion Criteria:

• Patients with chest pain or SOB admitted for rule out acute coronary syndrome
• Age ≥45 years
• EKG non-diagnostic for acute coronary syndrome
• At least 1 set of negative troponin I

Exclusion Criteria:

• Patient with ST elevation myocardial infarction.
• Patients with non-ST elevation myocardial infarction.
• Patients with known CAD.
• Patients with serum creatinine > 1.5.
• Atrial fibrillation or marked irregular heart rhythm.
• Patients in whom heart rate cannot be controlled.
• Patient with allergies to iodinated contrast agents.
• Pregnant women
• Patients unable to give informed consent