53 year-old female with acute chest pain

 

Images

Doctor's Information

Name : Ali
Family :Shirkhoda
Affiliation : Oakland University William Beaumont School of Medicine, University of California at Irvine and Wayne State University
Academic Degree: Professor of Radiology
Email : This email address is being protected from spambots. You need JavaScript enabled to view it.
Resident : ----------------

 

Patient's Information

Gender : Female
Age : 53

 

Case Section

Cardiovascular

 

Clinical Summary

53 year-old female with acute chest pain

 

 

Imaging Procedures and Findings

Axial contrast-enhanced chest CT images obtained at level of heart show sharply demarcated area of decreased enhancement in anterior wall of left ventricle, apex and interventricular septum consistent with acute MI. Notice that the ventricular wall does enhance at some levels.

 

Discussion

Initial acute MI is detectable on contrast-enhanced chest CT as a focal area of decreased left ventricular myocardial enhancement in a specific coronary arterial distribution. This finding is clinically relevant because contrast-enhanced chest CT is performed for indications such as suspected pulmonary embolism and aortic dissection, which have clinical features that overlap those of acute MI. Atypical presenting symptoms occur in 20??60% of patients with acute MI this trend is especially true for women. If acute MI is evident on CT, the diagnosis can be suggested, leading to appropriate triage of the patient. acute MI is detectable on contrast-enhanced chest CT as decreased left ventricular enhancement in a specific coronary artery distribution, related to the clinical infarct. Chest CT is performed for indications such as suspected pulmonary embolism and aortic dissection, which have clinical features similar to those of acute MI. If findings indicative of acute MI are evident on CT, that diagnosis can be suggested, leading to appropriate triage of the patient.

 

Final Diagnosis

Acute Myocardial Infarction

 

References

Gosalia A, Haramati LB, Sheth MP, Spindola-Franco H: CT Detection of Acute Myocardial Infarction. American Roentgen Ray Society 182:1563-1566, 2004.

 

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