[Cardiac CT and MRI in acute coronary syndrome]

Area of Science:

• Cardiology
• Medical Imaging
• Emergency Medicine

Context:

• Acute coronary syndrome (ACS) is a major diagnostic and therapeutic emergency, affecting an estimated 300,000 individuals annually in France.
• Atypical chest pain necessitates rapid differential diagnosis to exclude life-threatening conditions.
• Atheroma-related cardiovascular events present significant challenges in emergency settings.

Purpose:

• To outline the role of advanced imaging modalities in the emergency diagnosis and management of acute coronary syndromes.
• To detail how computed tomography (CT) and cardiac magnetic resonance imaging (MRI) aid in differentiating critical chest conditions.
• To highlight the prognostic value of cardiac MRI in assessing myocardial viability and guiding treatment decisions for ACS.

Summary:

• Coronary, aortic, and pulmonary CT scans are crucial for emergency specialists to rapidly exclude diagnoses such as coronary disease, pulmonary embolism, and aortic dissection in patients with atypical chest pain.
• Following initial management of ACS, cardiac MRI provides essential data for cardiologists to evaluate patient prognosis, particularly by assessing myocardial viability.
• In cases of ACS with normal coronary angiography, cardiac MRI is instrumental in distinguishing between myocardial infarction, myocarditis, and Tako-Tsubo syndrome.

Impact:

• Improved diagnostic accuracy in emergency departments for patients presenting with chest pain.
• Enhanced prognostic assessment and personalized treatment strategies for acute coronary syndrome patients.
• Facilitation of timely and appropriate management decisions, potentially reducing morbidity and mortality associated with cardiovascular emergencies.