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Identifying Coronary Artery Calcification on Non-gated Computed Tomography Scans
Published on: August 28, 2018
Things We Do for No Reason™: Overlooking incidental coronary artery calcification (iCAC)
Kristie J Sun1,2, Seamus P Whelton3, Leonard Feldman3
1Department of Radiology, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
None:
A 58-year-old man with no significant medical history or prescribed medications, including coronary artery disease, presented to the emergency department with hypoxemia due to COVID-19. A non-contrast chest computed tomography (CT) ordered to evaluate for the cause of the patient's hypoxemia revealed mild ground-glass opacities and moderate incidental coronary artery calcium (iCAC), noted in the body of the report. The CT report impression only reads "Peripheral ground glass opacities in keeping with COVID-19 infection." The hospitalist, unsure of what do for moderate iCAC, discharged the patient to follow-up with his primary care provider without addressing it. Eighteen months later, the patient returned to the emergency department with an acute myocardial infarction.
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