Triage of @entity1 with acute, potentially life-threatening @entity662 is one of the most important issues currently facing physicians in the emergency department. Appropriate evaluation of these @entity1 begins with a skilled assessment of the individual @entity1 's presenting symptoms and a careful review of his or her history and physical examination, often followed by serial recording of electrocardiograms and measurement of serum biochemical markers such as troponin and d-dimer. Stress testing, often accompanied by rest and stress myocardial perfusion imaging or echocardiography, and other diagnostic testing such as radionuclide lung scanning and invasive angiography may be required. A rapid, accurate, and cost-effective approach for the evaluation of emergency department @entity1 with @entity662 is needed. Development of newer generations of multidetector computed tomographic (MDCT) scanners, which are capable not only of performing high-quality noninvasive coronary angiography, but also concurrent aortic and pulmonary angiography, has led to increased use of MDCT for the so-called "triple rule out." MDCT is used for the detection of 3 of the most common life-threatening causes of @entity662 , @entity697 , and @entity1151 . While triple rule-out protocol can be very useful and potentially cost effective when used appropriately, concern has risen regarding the overuse of this technology, which could expose @entity1 to unnecessary radiation and iodinated contrast. The triple rule-out protocol is most appropriate for @entity1 who present with acute @entity662 , but are judged to have low to intermediate increased risk for @entity1187 , and whose @entity662 might also be attributed to acute pathologic conditions of the aorta or pulmonary arteries. MDCT should not be used as a routine screening procedure. Continued technical improvements in acquisition speed and spatial resolution of computed tomography images, and development of more efficient image reconstruction algorithms which reduce @entity1 exposure to radiation and contrast, may result in increased popularity of MDCT for "triple rule-out."

Evaluation of acute XXXX in the emergency department: "triple rule-out" computed tomography angiography.

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity1187 :: ('MESH:D054058', 'Disease') :: ['acute coronary syndrome'] @entity662 :: ('MESH:D002637', 'Disease') :: ['chest pain-coronary artery disease', 'chest pain symptoms', 'chest pain'] @entity697 :: ('MESH:D000208', 'Disease') :: ['acute aortic syndrome'] @entity1151 :: ('MESH:D011655', 'Disease') :: ['pulmonary emboli']
@entity662 :: (MESH:D002637,Disease) :: ['chest pain']
