The Significance of the Recently Published ACC/AHA Chest Pain Guidelines

Headshot of Brett Elicker, MD, chief of Cardiac and Pulmonary Imaging at UCSF Radiology The American College of Cardiology (ACC)/American Heart Association (AHA) recently published their ACC/AHA Chest Pain Guidelines. This marks the first update to these official clinical practice guidelines in nearly a decade. From an imaging perspective, CCTA and FFRct provide valuable diagnostic and treatment information. For referring cardiologists, significant changes worth noting include:

  • Elevating coronary computed tomography angiography (CCTA) as the only Class 1 noninvasive test with Level A evidence for diagnosing coronary artery disease (CAD) and guiding treatment decisions.
  • Endorsing fractional flow reserve derived from CT (FFRct) for providing actionable information to guide coronary revascularization in patients with stable or acute chest pain, whether with suspected or known CAD (Class 2a).
  • Limiting Stress Tests: With a limited, diagnostic-only role, functional testing is not endorsed to provide actionable information or to guide treatment (Class 1 B)

“It is exciting and potentially game-changing to make coronary computed tomography angiography (CCTA) one of the first-line noninvasive tests for chest pain. CCTA provides a detailed anatomic evaluation of the coronary arteries, similar to that of cardiac catheterization, and allows for either prompt diagnosis of coronary artery stenosis or rapid discharge if no significant disease is detected.  All of this is great news for patients and clinicians,” says Brett Elicker, MD, professor and chief of the Cardiac and Pulmonary Imaging Section in the UC San Francisco Department of Radiology and Biomedical Imaging.

The Cardiac and Pulmonary Imaging Section at UCSF Radiology is dedicated to safely performing the most current clinical imaging exams of both the respiratory and cardiovascular systems using advanced imaging modalities, such as detailed CTA and CT exams. Learn more.

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