Chest pain is often attributed to an impending heart attack. But the symptoms can be caused by other conditions, like heart burn, panic attack, infection, pulmonary embolism, shingles or sore muscles. In fact, researchers estimate only 30 percent of those who are admitted to a hospital for chest pain are found to have symptoms that are heart-related. But doctors don’t like to dismiss the symptoms and send the patient home because even low-risk patients may have undetected heart problems.

To determine the cause of chest pain, emergency physicians perform a variety of tests. Blood tests measure the levels of enzymes that increase after heart muscle damage. An EKG (electrocardiogram, also referred to as ECG) records the electrical activity of the heart. Stress testing looks at how the heart responds to exertion and increased demand by the body for oxygenated blood. A chest X-ray looks for abnormalities of the heart or other internal organs. Cardiac catheterization uses a radio-opaque dye and X-rays to see how well blood flows through the heart and find out if any of the coronary arteries are narrowed or blocked.

If the results of these tests are uncertain, doctors may perform other tests to look for potential non-heart-related causes of the pain. CT (computed tomography) scans use a series of X-rays to create images of internal structures of the body, like the heart. During a scan, the patient lies on a table while a machine rotates around the body to take multiple X-rays from many angles. In some cases, an X-ray dye may be injected into the circulatory system to highlight certain blood vessels. A computer analyzes and compiles the information to create an image.

Recently, researchers from the University of Washington Medical Center in Seattle compared the use of cardiac CT against standard diagnostic tests for patients being evaluated in the emergency room for chest pain. Radiologist, William Shuman, M.D., says each of the participants in the study was at low-risk for heart-related problems and was followed from the time of admission to the ER to discharge.

The investigators found that, when used early in the evaluation process, cardiac CT scans improved the speed and accuracy of the final diagnosis. Patients who had CT scans were able to leave the hospital in five hours. For patients who received standard diagnostic work-ups, the average stay was more than 24 hours. Faster diagnostic time and use of fewer tests also influenced the cost of patient charges – about $4,300 for those having the CT scan versus $7,600 for those receiving standard care.

Shuman says, in his experience, 85 to 90 percent of patients who come to the ER for chest pain have non-heart-related symptoms. When patients have few risk factors for heart disease, the CT scan can accurately predict who can be safely sent home and who needs further evaluation or treatment.