Athero
sclerotic cardiova
scular di
sea
se i
s the leading cau
se of death for both men and women in the United State
s. Coronary artery di
sea
se ha
s a long a
symptomatic latent period and early targeted preventive mea
sure
s can reduce mortality and morbidity. It i
s important to accurately cla
ssify individual
s at elevated ri
sk in order to identify tho
se who might benefit from early intervention. Imaging advance
s have made it po
ssible to detect
subclinical coronary athero
sclero
si
s. Coronary artery calcium
score correlate
s clo
sely with overall athero
sclerotic burden and provide
s u
seful progno
stic information for patient management. Our purpo
se i
s to di
scu
ss u
se of diagno
stic imaging in a
symptomatic patient
s at elevated ri
sk for future cardiova
scular event
s. The goal for the
se patient
s i
s to further refine targeted preventative effort
s ba
sed on ri
sk. The following imaging modalitie
s are available for evaluating a
symptomatic patient
s at elevated ri
sk: radiography, fluoro
scopy, multidetector CT, ultra
sound, MRI, cardiac perfu
sion
scintigraphy, echocardiography, and PET.
The ACR Appropriateness Criteria are evidence-based guidelines for specific clinical conditions that are reviewed every 2 years by a multidisciplinary expert panel. The guideline development and review include an extensive analysis of current medical literature from peer-reviewed journals and the application of a well-established consensus methodology (modified Delphi) to rate the appropriateness of imaging and treatment procedures by the panel. In those instances where evidence is lacking or not definitive, expert opinion may be used to recommend imaging or treatment.