PUMA
Istituto di Fisiologia Clinica     
Picano E. The Risks of Inappropriateness in Cardiac Imaging. In: International Journal of Environmental Health Research, vol. 6 pp. 1649 - 1664. Creative commons, 2009.
 
 
Abstract
(English)
The immense clinical and scientific benefits of cardiovascular imaging are wellestablished, 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.
DOI: 10.3390/ijerph6051649
Subject Cardiac imaging


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