Triple rule-out MDCT-angiography for chest pain in emergency room

NADER L. Triple rule-out MDCT-angiography for chest pain in emergency room. Med Emergency, MJEM 2015; 23:10-4.

Key words: Acute coronary syndrome, aortic dissection, chest pain, emergency department, pleural disease, pericardial disease, pulmonary embolism, triple rule-out MDCT-angiography

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Correspondent author: Lucie NADER, MD, MHS, EMBA

Radiologist-Cardiovascular Imaging

Nawfal Medical Center, Byblos, Lebanon

El Arz Hospital, Beirut, Lebanon

Category: Review article

Received: Apr. 8, 2015

Revised: Apr. 22, 2015

Accepted: May 6, 2015

There is no conflict of interest to declare


One of the most common symptoms encountered in emergency rooms (ER) is chest pain. It does not only have cardiac origin, differential diagnoses include vascular origin of pain as acute aortic dissection and pulmonary origin of pain such as pulmonary embolism. Several articles have demonstrated the importance and accuracy of a triple rule-out (TRO) multidetector computed tomography angiography (MDCT-angiography) for managing chest pain in the ER. This article is a review of the “TRO” MDCT-angiography for chest pain in ER. While there are many exams for every clinical diagnosis, there is no diagnostic technique that can provide as comprehensive evaluation and allow quick diagnostic orientation and targeted taking care for chest pain in the emergency department as TRO MDCT-angiography. TRO MDCT-angiography is the examination of choice to perform in the emergency department for patient with chest pain. It can assess the coronary arteries, the pulmonary arteries, the thoracic aorta and other thoracic diseases.

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