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The Risks of Inappropriateness in Cardiac Imaging
AbstractThe immense clinical and scientific benefits of cardiovascular imaging are well-established, but are also true that 30 to 50% of all examinations are partially or totally inappropriate. Marketing messages, high patient demand and defensive medicine, lead to the vicious circle of the so-called Ulysses syndrome. Mr. Ulysses, a typical middle-aged “worried-well” asymptomatic subject with an A-type coronary personality, a heavy (opium) smoker, leading a stressful life, would be advised to have a cardiological check-up after 10 years of war. After a long journey across imaging laboratories, he will have stress echo, myocardial perfusion scintigraphy, PET-CT, 64-slice CT, and adenosine-MRI performed, with a cumulative cost of >100 times a simple exercise-electrocardiography test and a cumulative radiation dose of >4,000 chest x-rays, with a cancer risk of 1 in 100. Ulysses is tired of useless examinations, exorbitant costs. unaffordable even by the richest society, and unacceptable risks.
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Picano, E. The Risks of Inappropriateness in Cardiac Imaging. Int. J. Environ. Res. Public Health 2009, 6, 1649-1664.View more citation formats
Picano E. The Risks of Inappropriateness in Cardiac Imaging. International Journal of Environmental Research and Public Health. 2009; 6(5):1649-1664.Chicago/Turabian Style
Picano, Eugenio. 2009. "The Risks of Inappropriateness in Cardiac Imaging." Int. J. Environ. Res. Public Health 6, no. 5: 1649-1664.