4.8 • 3.1K Ratings
🗓️ 3 July 2017
⏱️ 69 minutes
🧾️ Download transcript
Master the evaluation of acute and chronic chest pain with coronary CT angiography (CCTA). We deconstruct this game changing technology w/experts from the Society for Cardiovascular Computed Tomography (SCCT), Dr. Todd Villines and Dr. Ahmad Slim. We’ve got answers on what to do when a patient with chest pain has a prior CAC score of zero, and/or a CCTA with non-obstructive disease. Plus: how to select, prepare, and counsel patients; how to interpret reports; choosing between myocardial perfusion study and CCTA, and more!
Special thanks to Dr. Emilio Fentanes from SCCT for setting up this interview.
Full show notes available at http://thecurbsiders.com/podcast
Join our newsletter mailing list. Rate us on iTunes, recommend a guest or topic and give feedback at [email protected].
Case: 45 yo F active duty Colonel with chronic chest pain syndrome despite negative conventional stress test and CAC score of zero.
Time Stamps
00:00 Intro
04:00 Rapid fire questions
08:23 Book recommendations
10:14 Defining terms CCTA vs CAC
12:47 Script for counseling patient about CCTA
14:34 Prep for CCTA
16:40 Why is CCTA controversial?
19:37 Patient selection for CCTA both acute and chronic
25:20 Chronic chest pain and CCTA
27:58 CAC and CCTA in high risk occupations
33:25 Clinical case
36:10 Acute chest pain in patient w/CAC score zero
39:18 Acute chest pain in patient w/CAC score zero and previous CCTA w/non-obstructive CAD
41:22 How to read a CCTA report
45:48 CCTA versus conventional testing and risk MI, death
49:18 Use of CCTA in outpatients
52:16 Plaque characteristics and risk ACS
55:51 CCTA w/non-obstructive disease in patients with acute chest pain
58:14 When is myocardial perfusion scanning better?
61:00 Listener question on small vessel disease
62:09 Take home points
65:00 Curbsiders recap
69:33 Outro
Click on a timestamp to play from that location
0:00.0 | Welcome back to the Curbsiders. |
0:07.0 | Well, hello, Matthew. How are you doing? I'm okay. I'm okay. I'm a bit tired. I've |
0:19.0 | moved to the East Coast steward, so it's quite late here right now as we are recording this |
0:23.5 | intro after a very long and informative conversation. Paul, Paul, we're sorry that your |
0:30.5 | connection dropped out halfway through this or less than halfway through this. I don't |
0:35.9 | know when. How are you doing? I'm great. Yeah, I could hear everything just fine. So I got |
0:40.5 | a lot out of this. I just had as per usual, not much to contribute. So it's not much has |
0:45.0 | changed for me. So for me, this is a fantastic episode. Well, thanks, Paul. Okay. Well, we weren't |
0:50.5 | all going to give our picks of the week, but I know steward had a very special pick of |
0:55.7 | the week that he wanted to talk about. Oh, that was amazing. Yes. So the facility that I work |
1:02.6 | in is trying to save money. And so when I went to go use the restroom, I noticed that they |
1:07.7 | installed some some type of security measure on the toilet paper. You can only take two |
1:12.2 | squares of single-ply toilet paper. So my pick of the week is two squares of single-ply |
1:17.1 | toilet paper. And this is no more. You work at cashlack memorial hospital. Is that correct? |
1:23.1 | It is definitely cashlack. Well, so it's not a misnomer. No, not this time. Definitely |
1:31.1 | lacking cash. Okay. I have absolutely nothing. I the wheels are spinning and I got nothing |
1:37.3 | for it. I mean, I could I could I could recommend plenty of things, but I'll save it. Stewards |
1:43.9 | pick was so good that I think the audience that's that's all they need. I did want to introduce |
1:49.3 | this episode. First, I wanted to thank Dr. Emilio Fentanez, whose last name I most surely mispronounced |
1:56.3 | because that's my thing. But Emilio, thank you so much for setting this up. Emilio works for |
2:01.5 | he is a cardiologist and he is part of the society for cardiovascular computed tomography |
2:07.5 | also known as the SCCT and they are having their 12th annual meeting in July. And this |
... |
Please login to see the full transcript.
Disclaimer: The podcast and artwork embedded on this page are from The Curbsiders Internal Medicine Podcast, and are the property of its owner and not affiliated with or endorsed by Tapesearch.
Generated transcripts are the property of The Curbsiders Internal Medicine Podcast and are distributed freely under the Fair Use doctrine. Transcripts generated by Tapesearch are not guaranteed to be accurate.
Copyright © Tapesearch 2025.