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Review ArticlePratique

Investigation de la douleur thoracique chez des patients à risque faible ou intermédiaire

Quel est le meilleur test de premier recours pour éliminer la coronaropathie?

Connor T.A. Brenna, Fahmeen J. Afgani, Kate Hanneman, Deborah Levitan, Jacob A. Udell, R. Sacha Bhatia, Paula J. Harvey and Elsie T. Nguyen
Canadian Family Physician January 2020; 66 (1) e1-e8;
Connor T.A. Brenna
Étudiant en médecine à l’Université de Toronto, en Ontario.
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Fahmeen J. Afgani
Coordonnatrice de la recherche au Women’s College Research Institute de l’Hôpital Women’s College à Toronto.
MB BS
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Kate Hanneman
Professeure adjointe au Joint Department of Medical Imaging à l’Hôpital Toronto General.
MD MPH FRCPC
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Deborah Levitan
Médecin de famille au département de médecine familiale de l’Hôpital Women’s College.
MD CCFP
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Jacob A. Udell
Professeur agrégé à la division de cardiologie de l’Hôpital Women’s College.
MD MPH FRCPC
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R. Sacha Bhatia
Cardiologue et directeur de l’Institute for Health System Solutions and Virtual Care à la division de cardiologie de l’Hôpital Women’s College.
MD MBA FRCPC
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Paula J. Harvey
Directrice du programme de recherche cardiovasculaire à la division de cardiologie de l’Hôpital Women’s College.
BM BS PhD FRACP
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Elsie T. Nguyen
Professeure agrégée au Joint Department of Medical Imaging à l’Hôpital Toronto General.
MD FRCPC
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  • For correspondence: elsie.nguyen@uhn.ca
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    Figure 1.

    Trajectoire diagnostique proposée pour les patients souffrant de douleur thoracique à risque faible ou intermédiaire de coronaropathie

    AIC—angiographie invasive par cathéter, CG—artère coronaire gauche, coro-TDM—coronarographie par tomodensitométrie, ECG—électrocardiographie, SCA—syndrome coronarien aigu, TEMP—tomographie par émission monophotonique

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    Tableau 1.

    Rendement des diverses modalités d’imagerie chez les patients souffrant de douleur thoracique stable et de coronaropathie avérée ou soupçonnée comparativement à l’angiographie invasive par cathéter comme norme de référence

    MODALITÉSENSIBILITÉ, %SP.CIFICIT., %VPP, %VPN, %
    ECG à l’effort8,57,5845–5085–907591
    Échographie à l’effort8,57–5979–8580–884090
    TEMP8,24–26,6076–9170–906768
    IRM cardiaque30,31,6179–9180–927791
    Coro-TDM8,35,45,4678–9131–6844–6495–100
    FFR dérivée de la TDM45,46,60,62–6484–9365–8352–8284–100
    • Coro-TDM—coronarographie par tomodensitométrie, ECG—électro-cardiographie, FFR—réserve de débit fractionnaire, IRM—imagerie par résonance magnétique, TDM—tomodensitométrie, TEMP—tomographie par émission monophotonique, VPN—valeur prédictive négative, VPP—valeur prédictive positive.

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Canadian Family Physician: 66 (1)
Canadian Family Physician
Vol. 66, Issue 1
1 Jan 2020
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Investigation de la douleur thoracique chez des patients à risque faible ou intermédiaire
Connor T.A. Brenna, Fahmeen J. Afgani, Kate Hanneman, Deborah Levitan, Jacob A. Udell, R. Sacha Bhatia, Paula J. Harvey, Elsie T. Nguyen
Canadian Family Physician Jan 2020, 66 (1) e1-e8;

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Investigation de la douleur thoracique chez des patients à risque faible ou intermédiaire
Connor T.A. Brenna, Fahmeen J. Afgani, Kate Hanneman, Deborah Levitan, Jacob A. Udell, R. Sacha Bhatia, Paula J. Harvey, Elsie T. Nguyen
Canadian Family Physician Jan 2020, 66 (1) e1-e8;
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