Multislice coronary computed tomographic angiography in emergency department presentations of unsuspected acute
Harvey S Hecht1, Tandeep Bhatti
1Lenox Hill Heart and Vascular Institute, 130 E 77th Street, New York, NY 10021, USA. hhecht@lenoxhill.net
Background:
Coronary computed tomographic angiography (CCTA) is not indicated in the setting of acute myocardial infarction in the emergency department (ED). Nonetheless, acute coronary syndromes may have atypical presentations, and CCTA may be inadvertently performed in this setting.
Objectives:
This study was designed to determine the frequency and characteristics of CCTA imaging of unsuspected acute myocardial infarction in the ED.
Methods:
All CCTAs performed in the ED at Lenox Hill Hospital were reviewed for clinical indications and subsequent course; patients with documented acute myocardial infarction were identified.
Results:
Of the 500 CCTAs performed on ED patients in the Lenox Hill laboratory, 5 patients (1%) were imaged during the initial phase of an unsuspected acute myocardial infarction; in all cases the CCTAs were key to the diagnosis. The imaging characteristics were (1) total or subtotal occlusion and (2) transmural hypodensity in the infarct area.
Conclusion:
Although acute myocardial infarction on CCTA in ED patients is an infrequent event, proper and prompt recognition is critical for appropriate patient care, particularly as applications to the ED increase.
More Related Videos
06:29Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
09:32Time-Resolved, Dynamic Computed Tomography Angiography for Characterization of Aortic Endoleaks and Treatment Guidance via 2D-3D Fusion-Imaging
Published on: December 9, 2021
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:28Imaging Studies for Cardiovascular System V: CT
01:30Acute Coronary Syndrome I: Introduction
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT
01:21Imaging Studies for Cardiovascular System IV: CMRI
01:10Computed Tomography
The technique was invented in the 1970s and is based on the principle that as X-rays pass through the body, they are absorbed or reflected at different levels. In the technique, a patient lies on a motorized platform while a computerized axial tomography (CAT) scanner rotates...