CT angio - Life time of xrays

The 29th June 2008 issue of the New York Times, carried a stinging article on the misuse of the 64MSCT angio. A Berenson and R Abelson, did a great piece of investigative journalism, quoting patients, third party payers and also numerous physicians on both sides of the MSCT divide. Sometimes we forget to consider the long term consequences of such procedures. Basically, it states ( as we have always maintained ) that MSCT angios area overused and often, in situations where their usefulness have never been proven. What with the very real radiation risk. Each 64MSCT angio with the present scans that we have carries a radiation exposure of about 500-1000 CXRs. This danger is seldom told to the patient. Of course there is always the danger that these scans may be routinely done as a checkup for CAD ( although there is no evidence of that it helps ), because cardiologist reading the scans get a hefty fee for reporting. The fact that many cardiologist have become shareholders of companies owning these scan machines, further fuel these impressions. Many assymptomatic, healthy males or females, go for a checkup, and were advised to undergo a 64MSCT cardiac angio. stenosis are seen and they end up having a formal coronary angiogram. These often result in angioplasty and stent implantation, including DES. All on the premise that treating assymptomatic stenosis prevents heart attacks and cardiac death, although there is no evidence for that premise. In fact, there is much evidence that assymptomatic stenosis may do better with intensive medical therapy. Well, therein lies the danger of physician owning healthcare facilities, and the resulting severe conflict of interest. Each of us should get the 29th June issue of the NY Times, and appreciate this article for yourselves.