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A tale of comet tail: multiple pellets in the heart
R Kanyal1, Waleed Arshad1, Arvinder Kurbaan1
1Department of Cardiology, Homerton Hospital, London, UK.
BMJ Case Reports
|October 19, 2014
Summary
A CT coronary angiogram revealed multiple hyperdense bodies in a patient with chest pain. Echocardiography showed an uncommon comet tail artifact, but no other cardiac abnormalities were detected.
Area of Science:
- Cardiology
- Medical Imaging
Background:
- Chest pain is a common symptom requiring thorough diagnostic evaluation.
- Computed tomography (CT) coronary angiography is a key imaging modality for assessing coronary artery disease.
Observation:
- A 66-year-old male patient presented with acute chest pain.
- CT coronary angiogram identified multiple hyperdense bodies within the coronary arteries.
- Transthoracic echocardiography revealed a comet tail artifact, an unusual finding.
Findings:
- The hyperdense bodies on CT coronary angiogram were not further characterized but suggested potential calcifications or emboli.
- The comet tail artifact on echocardiography, while uncommon, did not correlate with other structural or functional cardiac abnormalities.
- No other significant abnormalities were identified on either imaging modality.
Implications:
- This case highlights the importance of correlating findings from different imaging modalities.
- The presence of hyperdense bodies warrants further investigation to determine their etiology and clinical significance.
- Understanding uncommon echocardiographic artifacts like the comet tail is crucial for accurate diagnostic interpretation.