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Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
06:29

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques

Published on: June 11, 2019

Coronary thrombus detected by cardiac CT angiography before cardiac catheterization

Ahmad M Slim1, Jennifer N Slim, Brian R Haney

  • 1Cardiology Service, Brooke Army Medical Center, Fort Sam Houston, TX, USA. Ahmad.slim@us.army.mil

Journal of Thoracic Imaging
|May 14, 2010
PubMed

Insights

This case report details the first instance of detecting a coronary artery thrombus using CT angiography in a patient with chest discomfort. This imaging technique proved effective in diagnosing the clot, aiding in prompt patient treatment.

Area of Science:

  • Cardiology
  • Radiology
  • Medical Imaging

Background:

  • Myopericarditis and myocardial infarction are serious cardiac conditions often presenting with chest discomfort.
  • Coronary CT angiography (CCTA) is a valuable non-invasive tool for evaluating acute chest pain.
  • Early and accurate diagnosis of coronary artery thrombus is crucial for patient outcomes.

Observation:

  • A patient presented with pleuritic chest discomfort and elevated cardiac biomarkers, initially suspected of myopericarditis.
  • Cardiac MRI revealed a potential myocardial infarct, prompting a coronary CT scan.
  • The coronary CT scan identified a thrombus in the left anterior descending artery.

Findings:

  • Cardiac catheterization confirmed the presence of a coronary artery thrombus.
  • A small clot was successfully removed.
  • This represents the first reported case of coronary thrombus diagnosed by CCTA with subsequent cardiac catheterization correlation.

Implications:

  • CCTA demonstrates high utility in diagnosing coronary artery thrombus, even in cases initially suspected of myopericarditis.
  • The negative predictive value of CCTA for acute chest pain approaches 100%, making it a reliable diagnostic tool.
  • This case highlights the importance of considering CCTA in young patients with unexplained chest discomfort and cardiac biomarker elevation.

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