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Acute myocardial infarction found by multi-detector computed tomography ordered for suspected aortic dissection

Sherwin S W Lo1, W K Kwok

  • 1Department of Radiology, Pamela Youde Nethersole Eastern Hospital, Chai Wan, Hong Kong. sherwinlo@gmail.com

Hong Kong Medical Journal = Xianggang Yi Xue Za Zhi
|June 6, 2008
PubMed

Insights

Urgent chest computed tomographic scans can mimic acute myocardial infarction. Two cases showed decreased myocardial enhancement on CT scans, later confirmed as myocardial infarction by coronary angiography.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Computed tomographic (CT) scans of the thorax are frequently requested urgently for suspected aortic dissections and pulmonary embolisms.
  • These conditions share overlapping clinical symptoms with acute myocardial infarction (MI).

Observation:

  • Two cases presented with CT scans demonstrating reduced myocardial enhancement.
  • This finding was initially suggestive of acute myocardial infarction.

Findings:

  • The CT scans showed no evidence of aortic dissection in either case.
  • Subsequent coronary angiography confirmed acute myocardial infarction in both patients.

Implications:

  • Decreased myocardial enhancement on contrast-enhanced CT may indicate acute myocardial infarction, even without other typical signs.
  • Radiologists and clinicians should consider acute MI in the differential diagnosis for patients with these CT findings.
  • This highlights the importance of correlating imaging findings with clinical presentation and further diagnostic tests.

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