Double Rule In: Concomitant Acute Coronary Occlusion and Pulmonary Embolism

Area of Science:

• Cardiovascular Imaging
• Emergency Medicine
• Radiology

Background:

• Computed tomography angiography (CTA) is a key diagnostic tool in emergency departments for patients with acute chest pain.
• CTA is routinely used to exclude obstructive coronary artery disease (CAD) and pulmonary embolism (PE).

Purpose of the Study:

• To highlight the rarity of diagnosing concomitant acute coronary occlusion and pulmonary embolism on a single CTA scan.
• To emphasize the diagnostic challenges and implications of identifying these two critical conditions simultaneously.

Main Methods:

• Review of computed tomography angiography (CTA) scans in emergency department patients presenting with acute chest pain.
• Analysis of cases where both acute coronary occlusion and pulmonary embolism were identified concurrently.

Main Results:

• Computed tomography angiography (CTA) is frequently employed for the "double rule out" of coronary artery disease and pulmonary embolism.
• The simultaneous diagnosis of acute coronary occlusion and pulmonary embolism on a single CTA scan is an exceptionally uncommon finding.

Conclusions:

• While CTA is effective for evaluating acute chest pain, the co-occurrence of acute coronary occlusion and pulmonary embolism is a rare diagnostic scenario.
• Clinicians should be aware of this rare possibility, although it is seldom encountered in routine practice.