Economic analysis of the use of coronary calcium scoring as an alternative to stress ECG in the non-invasive diagnosis of coronary artery disease.

Objective: To conduct an economic analysis (EA) of coronary calcium scoring (CCS) using a 0 score, as alternative to stress electrocardiography (sECG) in diagnosing coronary artery disease (CAD).

Method: A decision tree was constructed to compare four strategies for investigation of suspected CAD previously assessed in the formulation of clinical guidelines for the United Kingdom (UK) to two new strategies incorporating CCS. Sensitivity (96%; 95% CI 95.

Aortic root abscess: multimodality imaging with computed tomography and gallium-67 citrate single-photon emission computed tomography/computed tomography hybrid imaging.

Culture negative endocarditis and aortic root abscess can prove difficult diagnostic challenges. Computed tomography can be extremely useful in this setting. We report a case of an aortic root abscess 3 months after elective aortic valve replacement in which cardiac CT and hybrid imaging with Gallium-67 SPECT complemented workup with transesophageal echocardiography in establishing the diagnosis of an abscess.

Perforation of right ventricular free wall by pacemaker lead detected by multidetector computed tomography.

Pacemaker lead perforation is a recognized complication of lead implantation, particularly with active fixation leads. Multidetector computed tomography (MDCT) is emerging as the imaging modality of choice in diagnosing lead perforation, identifying associated sequelae such as pericardial effusion and planning extraction. We present a case illustrating the use of MDCT in a case of right ventricular (RV) lead perforation manifesting 5 days after cardiac resynchronization therapy pacing.

Right atrial mass in the context of recurrent non-Hodgkin's lymphoma: atrial myxoma presenting with atrial flutter.

A case is described of a 57-year-old man with a background of low-grade bronchus-associated lymphoid tissue (BALT) non-Hodgkin's lymphoma presenting with dyspnoea and palpitations. Diagnostic work-up revealed paroxysmal atrial flutter and the presence of a mass in the right lower lobe at bronchoscopy, with histology confirming recurrent BALTOMA. Transthoracic echocardiography (TTE) revealed a mass in the right atrium.

Computed tomography of a broken heart: chronic left ventricular pseudoaneurysm.

The multislice cardiac computed tomography (CT) images of a 77-year-old man with a history of coronary artery bypass grafting and subsequent large left ventricular pseudoaneurysm (LVPA) formation are presented. Survival, as in this case, for several years after pseudoaneurysm formation is unusual without operative intervention. The case highlights the utility of CT in this scenario in allowing accurate assessment of LVPA anatomy, as well as noninvasive assessment of graft vessel patentcy, both vital to surgical planning in such high-risk cases.