MPI + CTA in patient with atypical chest pain
Teaching Case Visit Teaching Case
Case presentation:
- Female.
- 59 y.o.
- Atypical chest pain for the past 6 months.
- Total Cholesterol = 190; HDL = 40; LDL = 88 (on statins).
- Glucose: 0.93, HbA1C = 6.7 % (on insulin + metformin).
Teaching points:
- MPS investigates the pathophysiological consequences of luminal obstructive CAD, while CTA indicates the presence, extent and location of coronary atherosclerosis.
- For pratical purposes, CTA excludes CAD (high NPV).
- A negative CTA implies no need of MPS on follow-up.
- A positive CTA (if performed initially) implies the need for a MPS for short-term prognosis and eventual revascularization, because of low PPV.
- Combined anatomical and functional assessment may allow improved risk stratification.