Core Concepts
Overuse of cardiac imaging alarms leads to unnecessary referrals and anxiety in patients.
Abstract
The content discusses the overuse of cardiac imaging tools, particularly the identification of coronary artery calcium (CAC) testing, leading to unnecessary downstream testing and referrals. Patients often present with anxiety due to alarms triggered by incidental findings on non-cardiac CT scans. The National Lipid Association guidelines recommend CAC testing for specific patient groups, but many patients are referred without meeting the criteria. The presence of CAC triggers additional screening and referrals, potentially leading to unwarranted evaluations for atherosclerotic cardiovascular disease (ASCVD). Despite the potential benefits of using CAC data for statin prescriptions, there are concerns about unnecessary testing and interventions. Clinicians are advised to have informed discussions with patients about the implications of incidental findings and the necessity of further testing.
Key Highlights:
- Overuse of cardiac imaging tools leads to unnecessary referrals and anxiety in patients.
- Incidental findings of coronary artery calcium (CAC) trigger downstream testing and referrals.
- National Lipid Association guidelines recommend CAC testing for specific patient groups.
- Presence of CAC may lead to unwarranted evaluations for ASCVD.
- Benefits of using CAC data for statin prescriptions are weighed against potential risks.
- Clinicians should engage in informed discussions with patients about incidental findings and further testing.
Stats
"We're seeing a lot of referrals for patients who have incidentally detected calcium on some non-gated chest CT," said Matthew Tattersall, DO.
"We're seeing a lot of referrals for patients who have incidentally detected calcium on some non-gated chest CT," said Dr Matthew Tattersall.
"But they shouldn't necessarily be referred to get a stress test if they otherwise don't have any symptoms."
Quotes
"We don't like to have too much in the way of incidental findings because you always get down testing rabbit holes, right?"
"If someone comes in with very atypical pain, has a low pretest probability of ischemic heart disease, and has negative troponin testing, there's very little reason to do stress testing."