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The recently published National Institute for Health and Care Excellence (NICE) clinical guideline on ‘Chest pain of recent onset: assessment and diagnosis (CG95)’, suggests Computed Tomography Coronary Angiography (CTCA) as the rst line investigation for patients with stable chest pain if clinical assessment indicates typical or atypical angina, or non-anginal chest pain with ECG changes suggesting underlying coronary artery disease. Functional imaging or invasive angiography is recommended as a second-line investigation in those cases where CTCA is equivocal or positive i.

CTCA is a relatively new technique and therefore the number of professionals currently trained in its acquisition and reporting is limited. Also, high quality, low dose, CTCA also can only be performed using relatively modern CT equipment. For these reasons there is geographic variation in the availability and delivery of CTCA services within the UK.

Based on available data, the BSCI/BSCCT have assessed the current provision of CTCA
and modelled the expected demands on services, based on the current sustainability and transformation plan (STP) populations in England, and Health Boards in the devolved nations. This report, which we welcome, should prove helpful to commissioners of these services, to hospitals providing clinics for the assessment of those with suspected stable cardiac chest pain, and to those considering the workforce implications of providing CTCA services more widely and to national standards ii.

Professor Huon Gray

National Clinical Director for Heart Disease, NHS England

Dr Nicola Strickland

President, Royal College of Radiologists 


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