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Cardiology in focus
Cardiovascular CT: the role of cardiologists
  1. Muhummad Sohaib Nazir1,
  2. Edward D Nicol2
  1. 1 Imaging Sciences and Biomedical Engineering, King’s College London, London, UK
  2. 2 Departments of Cardiology and Radiology, Royal Brompton and Harefield NHS Foundation Trust, London, UK
  1. Correspondence to Dr. Edward D Nicol, Departments of Cardiology and Radiology, Royal Brompton and Harefield NHS Foundation Trust, London SW3 6NP, UK; e.nicol{at}nhs.net, cyprusdoc{at}doctors.org.uk

https://doi.org/10.1136/heartjnl-2018-314557

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    Role of cardiac CT

    CT is an increasingly pivotal diagnostic tool for cardiovascular disease and preprocedural planning for structural intervention and device implantation. CT coronary angiography (CTCA) has gained prominence in UK clinical practice as it is now recommended in the National Institute for Health and Care Excellence guidelines as the first-line test for the investigation of anginal symptoms in those without known coronary artery disease (CAD).1 CTCA is an excellent rule-out test for CAD (figure 1) but has an increasingly robust positive predictive value, especially when combined with CT-fractional flow reserve,2 which is currently being funded as part of an NHS England Innovation programme. Recent evidence has demonstrated the addition of CTCA to standard of care in patients from rapid access chest pain clinics reduced non-fatal myocardial infarction rates by over 40%.3

    Figure 1

    Typical CT coronary angiogram images of a patient referred …

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    Footnotes

    • Contributors EDN conceived the idea of this article. MSN and EDN jointly wrote this manuscript.

    • Funding This study was funded by the Medical Research Council (grant number MR/P01979X/1).

    • Competing interests None declared.

    • Provenance and peer review Commissioned; internally peer reviewed.

    • Patient consent for publication Not required.