The Prevalence of Extracardiac Abnormalities Identified in Negative Coronary Computed Tomography Angiography and Its Association with Clinical Symptoms

English (OpenAlex)

Coronary computed tomography angiography (CCTA) is valuable for assessing both coronary and incidental extracardiac findings. Recognizing non-cardiac causes of chest pain and dyspnea can improve diagnostic efficiency. This study aimed to assess the prevalence of extracardiac findings in patients with normal or non-obstructive CCTA and to determine whether these findings could account for their presenting symptoms, such as chest pain or exertional dyspnea. We retrospectively analyzed 358 patients who underwent coronary computed tomography angiography between January 2021 and December 2024 due to chest pain or dyspnea. Patients with obstructive coronary artery disease, congenital coronary anomalies, valvular disease, or acute coronary syndrome were excluded. Two experienced radiologists reviewed all scans for extracardiac abnormalities and evaluated their potential relationship with patient symptoms. Extracardiac findings were identified in 236 patients (65.9%), with vertebral degenerative changes (39.1%) being the most frequent, followed by atelectasis (14.8%) and emphysema (10.6%). Findings potentially explaining chest pain were noted in 56% of patients with this symptom, while 64% of those with exertional dyspnea had relevant extracardiac abnormalities. Female sex and older age were significantly associated with higher prevalence of extracardiac findings (p