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Abstract
INTRODUCTION:Acute chest pain is one of the most common reasons for seeking care in the emergency department (ED), accounting for approximately 10% of all visits. The difficulty lies in discriminating patients with ACS or other lifethreatening conditions from those with non-cardiovascular,non-life-threatening chest pain.The diagnosis ofACS is missed in approximately 2%ofpatients.But itis essential to rule out cardiovascular etiology of chestpain to avoidunnecessary cost and complications of investigations and treatment. This study aims at identifying the prevalence of significant coronary artery disease in patients with no electrocardiographic and biochemical evidence of coronary artery disease. AIM OF STUDY: To identifying the presence of severe coronary artery disease in the patients with no electrocardiographic, biochemical and echocardiographic evidence of CAD using CT Coronary Angiography. MATERIAL AND METHODS: The study was conducted on 50 patients during a period of 4 months,admitted with history of chest pain without any ECG evidence of STEMI, negative cardiac markers, no evidence of RWMA on 2D ECHO, or previous history of myocardial infarction.RESULTS: Out of the 50 patients studied, 38 (76%) were males and 12 (24%) were females.A total of 6 patients (12%) were found to have severe stenosis in major coronary arteries (stenosis > 70%) of which 4 were males (10.5%) and 2 were females (16.67%).CADRAD score≥3 was found in 9 patients (18%):6 males (15.78%) and 3 females (12%).Average age of patients who presented with chest pain with no electrocardiographic and biochemical evidence of coronary artery disease was found to be 61.7 years in males and 60.1 in females.66.7% of the female patients and 78.94% of male patients were over the age of 55 years.CONCLUSION: Furtherworkupofpatientswith chestpainwith no electrocardiographic and biochemicalevidenceofcoronaryarterydiseaseisnecessarytoavoidmissingdiagnosisofCAD
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