Can coronary CTA be used for a single study for a patient with chest pain to exclude cardiac ischemia, aortic dissection, and pulmonary embolus?
Extending the range of coronary CTA to include the entire chest for additional indications is possible. However, it involves increasing both the radiation dose and the dose of intravenous contrast material required for simultaneous opacification of the pulmonary arteries, coronary arteries, and aorta. The application of clinical acumen to focus the workup more narrowly whenever possible is preferable. If this “triple rule out” scan is to be attempted, prospective gating would be advantageous in minimizing the radiation dose.