Radiological Evaluation of Acute Chest Pain: A Review of Diagnostic Imaging Strategies

Abstract

Acute chest pain is a common clinical presentation that necessitates prompt and accurate diagnosis to differentiate between life-threatening conditions, such as myocardial infarction and pulmonary embolism, and less severe causes. The role of radiological evaluation in this context is critical. Various imaging modalities, including chest radiography, computed tomography (CT), and magnetic resonance imaging (MRI), have unique advantages in assessing structural abnormalities, vascular pathology, and pulmonary conditions. Chest X-rays remain the first-line imaging tool for ruling out pneumonia and pleural effusions, while CT angiography has become increasingly important for rapid assessment of coronary artery disease and aortic dissections. Consequently, the selection of the appropriate imaging strategy depends on the clinical context, the patient's presentation, and the urgency of diagnosis. Key considerations in the radiological evaluation of acute chest pain involve the balance between diagnostic accuracy, speed of imaging, and radiation exposure. While CT plays a pivotal role in quickly identifying critical conditions, its use must be judicious to minimize unnecessary radiation, especially in younger patients. MRI, though less commonly used in acute settings due to availability and longer acquisition times, offers excellent soft tissue characterization and can provide crucial information in cases of myocarditis or pericardial diseases. Overall, a systematic approach to radiological evaluation, integrating patient history, clinical examination, and appropriate imaging modalities, is essential for effective management of acute chest pain.