A 56-year-old woman presented to her cardiologist with stable atypical chest pain. A 20% pretest probability of coronary artery disease (CAD) was estimated, considering sex, age, and type of chest pain.1 Functional tests performed 3 months earlier were inconclusive: a stress electrocardiogram (ECG) showed ST-segment depressions at 100 W of −0.2 mV in lead I and −0.15 mV in V5, while stress magnetic resonance (MR) perfusion imaging had negative results. The patient had cardiovascular risk factors including arterial hypertension and a family history of CAD. With antihypertensive therapy, her blood pressure was 119/79 mm Hg. Blood lipids were as follows: total cholesterol, 167 mg/dL (abnormal >200 mg/dL); low-density lipoprotein cholesterol, 80 mg/dL (abnormal >100 mg/dL); high-density lipoprotein cholesterol, 55 mg/dL (abnormal <60 mg/dL); and triglycerides, 80 mg/dL (abnormal >150 mg/dL). To evaluate for CAD, she underwent coronary computed tomography (CT) angiography (Figure).
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Feger S, Dewey M. Coronary Computed Tomography Angiography. JAMA. 2020;324(14):1455–1456. doi:10.1001/jama.2020.10831
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