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Home Chest Pain-Possible Acute Coronary Syndrome
Variants
Scenario Scenario ID Procedure Adult RRL Peds RRL Appropriateness Category
Chest pain, high prob acute coronary syndrome, initial imaging 3164901
Radiography chest
<0.1 mSv
☢ 		<0.03 mSv [ped]
☢ 		Usually appropriate
Arteriography coronary
1-10 mSv
☢☢☢
Usually appropriate
US echocardiography transthoracic resting
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
US echocardiography transthoracic stress
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
MRI heart function and morphology without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		May be appropriate
(Disagreement)
CTA coronary arteries with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		May be appropriate
SPECT or SPECT/CT MPI rest only
1-10 mSv
☢☢☢
May be appropriate
(Disagreement)
SPECT or SPECT/CT MPI rest and stress
10-30 mSv
☢☢☢☢ 		10-30 mSv [ped]
☢☢☢☢☢ 		May be appropriate
US echocardiography transesophageal
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA coronary arteries without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRA coronary arteries without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart function and morphology without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart with function and inotropic stress without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart with function and inotropic stress without IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
MRI heart with function and vasodilator stress perfusion without and with IV contrast
0 mSv
O 		0 mSv [ped]
O 		Usually not appropriate
CT chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without and with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT chest without IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
CT coronary calcium
1-10 mSv
☢☢☢
Usually not appropriate
CTA chest with IV contrast
1-10 mSv
☢☢☢ 		3-10 mSv [ped]
☢☢☢☢ 		Usually not appropriate
Rb-82 PET/CT heart
10-30 mSv
☢☢☢☢
Usually not appropriate