Coronary Calcium Scoring Versus Standard Care for Emergency Department Chest Pain Patients

A Randomized Controlled Trial of Early Coronary Calcium Scoring and Standard Care in Emergency Department Chest Pain Patients

This research asks whether coronary calcium scoring, a non-invasive test based on computed tomography scanning, is a better way to diagnose chest pain patients than other currently used methods. Three of four patients will undergo calcium scoring and the remaining patients will receive standard care.

Inclusion Criteria:

• complaint of chest pain or pressure
• intermediate risk by HEART score
• clinical indication for non-invasive cardiac imaging
• free of known coronary artery disease

Exclusion Criteria:

• hemodynamic instability
• electrocardiogram suggestive of acute ischemia or myocardial infarction
• unremitting chest pain
• serum troponin levels greater than three times the laboratory threshold
• unable to give his/her own written, informed consent
• pregnant women
• weight > 182 kg
• unable to lie supine for scan
• coronary calcium score, coronary CTA or non-contrast thoracic CT within the last year and available for review
• unable to comply with 30 day follow-up