Ethics in Medicine

Radiation Risk and Coronary CT Scans

Kristen Sparrow • December 15, 2010

During the presentation by Dr. Rita Redberg on Coronary Artery Disease during the “Controversies in Women’s Health Conference” last week, she discussed the use of CT scans for screening and diagnosis of CAD. They are used to detect coronary calcium. She stated the astonishing fact that an estimated 1 in 270 women who have one of these scans at the age of 40 years will develop cancer from that CT!! She also said that based on CT scans done in 2007 alone there would be 30,000 cancers and 15000 excess deaths. She gave a horrific case study about a woman who was having abnormal chest pain that was unlikely to be angina. But, to reassure the patient, they did a coronary artery CT scan. They saw something suspicious and went to coronary cath. Her cath was normal without disease, but they dissected her Left Anterior Descending coronary artery and they had to go to emergency coronary artery bypass. She ended up with a heart transplant.
This underscores Dr. Redberg’s admonition that less is more, and that “reassurance” is not sufficient reason to order a study. First do no harm.

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