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The Risks of Inappropriateness in Cardiac Imaging

Author

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  • Eugenio Picano

    (Institute of Clinical Physiology, CNR, Pisa, Italy)

Abstract

The 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.

Suggested Citation

  • Eugenio Picano, 2009. "The Risks of Inappropriateness in Cardiac Imaging," IJERPH, MDPI, vol. 6(5), pages 1-16, May.
    • Handle: RePEc:gam:jijerp:v:6:y:2009:i:5:p:1649-1664:d:5038
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