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BackgroundCoronary computed tomography angiography is increasingly used as the first‐line test for suspected coronaryarterydisease. PTP was calculated according to the 2013 and 2019 ESC guidelines. Updated 2019 ESC guidelines classified 72% of the patients as having low PTP, whose imaging could have been deferred.
Atherosclerotic cardiovascular disease (ASCVD), caused by plaque buildup in arterial walls, is one of the leading causes of disability and death worldwide.1,2 1,2 ASCVD causes or contributes to conditions that include coronaryarterydisease (CAD), cerebrovascular disease, and peripheral vascular disease (inclusive of aortic aneurysm).3
63 years old Afsar Khan resident of Karwan, Hyderabad had been having coronaryarterydisease and chest pain on exertion for about a year. In November 2019, he underwent CT coronary angiography which showed blocks in all 3 coronaryarteries of the heart.
Takotsubo is a sudden event, not one with crescendo angina. Hospital Course The patient was taken emergently to the cath lab which did not reveal any significant coronaryarterydisease, but she was noted to have reduced EF consistent with Takotsubo cardiomyopathy. Learning Points: 1. Lindahl et al. References: 1.
I believe this is by far the most common outcome for this patient around the world in 2019. Current practice ranges widely, but based on my short experience and reports from other institutions, most of these patients are not being taken emergently to the cath lab in 2019. European Heart Journal 2019. Patel et al., Krucoff et al.)
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