الفهرس 
INTRODUCTIONOnly 14 pages are availabe for public view
 |  | from | 111 |  |  |
| | | from | 111 | | |
Abstract
Coronary artery disease (CAD) is the leading cause of global mortality, accounting for 13% of deaths across the world.
Chest pain is a common presenting symptom of CAD and widely considered a key symptom in its diagnosis, but not all patients present with typical anginal pain that make diagnosis of CAD easy. Some patients may present with atypical chest pain, Also there are other cardiac and non cardiac pathologies that may cause this atypical presentation of chest pain, so the initial clinical assessment in primary care should include the consideration of the typicality of chest pain.
Atypical angina is most frequently chest pain resembling that of typical angina in location and character but lacks one of the three characteristics of typical angina. The pain is responsive to nitrates but has no precipitating factors or pain of anginal location and quality, which is triggered by exertion or occurs some time after exertion and may be poorly responsive to nitrates.
Atypical chest pain can arise from a variety of etiologies. Cardiac causes including CAD and non CAD related etiologies ; aortic stenosis or dissection, an anomalous coronary artery, myocardial bridging, hypertrophic cardiomyopathy and primary or metastatic tumors. The non-cardiac causes includes ; pulmonary and gastrointestinal disorders such as esophageal spasm, peptic ulcer, cholecystitis and hiatus hernia.
Imaging of the heart has always been technically challenging because of the heart’s continuous motion. Later technical developments such as 64 slice and more ECG-synchronized multi-detector CT scanners allow for acquisition of large volume data in a very short time with a rotation time down to 0.165 s, and with high spatial and temporal resolution that eventually enable excellent visualization of both main coronary arteries and side branches with high diagnostic accuracy.
This is of clinical significance because the number of invasive coronary angiography examinations can be reduced or unnecessary invasive procedures can be avoided based on CCTA findings.
The aim of this study is to detect the ability of coronary computed tomography angiography to diagnosis and exclude CAD in patients presenting with atypical chest pain and identify other possible etiologies resembling its presentation.
This study was carried out on twenty patients (15 males and 5 females) with age ranged from 22 to 70 with a mean age of 46 years old, the patients were selected on the basis of clinical picture with symptoms of atypical anginal chest pain suspicious for the coronary artery disease. Patients with atypical anginal chest pain (probable) that meets only two of the three characteristics of typical anginal pain.
All patients were subjected to full history taking, thorough clinical examination and review of the laboratory investigations and of available previous imaging studies. Patients with heart rate >60 beat/min received