%0 Journal Article
%T The Risks of Inappropriateness in Cardiac Imaging
%A Eugenio Picano
%J International Journal of Environmental Research and Public Health
%D 2009
%I MDPI AG
%R 10.3390/ijerph6051649
%X 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 ˇ°worried-wellˇ± 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.
%K appropriateness
%K benefit
%K radiation
%K risk
%U http://www.mdpi.com/1660-4601/6/5/1649