title: Could contrast-enhanced CT detect STEMI prior to electrocardiogram?
abstract: We present here a case in which contrast-enhanced computed tomography (CT) was the first diagnostic tool to detect myocardial hypoperfusion in a patient with atypical symptoms and normal electrocardiogram (ECG) on admission. An ST-segment elevation was detected thereafter on a second ECG realized several minutes after CT with raised troponin levels. Percutaneous coronary intervention was performed after failure of thrombolysis and confirmed occlusion of the left anterior descending artery. Further studies are needed to evaluate the role of high-resolution contrast-enhanced CT with or without coronary angiography in the workup of suspected myocardial infarction in the setting of a normal ECG.
authors.affiliation: Emergency Department, Hotel Dieu de France Teaching Hospital, Saint Joseph University, Beirut, Lebanon.
authors.forename: Chadi
authors.initials: C
authors.lastname: Sabbagh
authors.affiliation: Emergency Department, Hotel Dieu de France Teaching Hospital, Saint Joseph University, Beirut, Lebanon.
authors.forename: Mayda
authors.initials: M
authors.lastname: Rahi
authors.affiliation: Internal Medicine Department, Hotel Dieu de France Teaching Hospital, Saint Joseph University, Beirut, Lebanon.
authors.forename: Maria
authors.initials: M
authors.lastname: Baz
authors.affiliation: Internal Medicine Department, Hotel Dieu de France Teaching Hospital, Saint Joseph University, Beirut, Lebanon.
authors.forename: Fadi
authors.initials: F
authors.lastname: Haddad
authors.affiliation: Radiology Department, Hotel Dieu de France Teaching Hospital, Saint Joseph University, Beirut, Lebanon.
authors.forename: Omar
authors.initials: O
authors.lastname: Helwe
authors.affiliation: Radiology Department, Hotel Dieu de France Teaching Hospital, Saint Joseph University, Beirut, Lebanon.
authors.forename: Noel
authors.initials: N
authors.lastname: Aoun
authors.affiliation: Hematology-Oncology Department, Hotel Dieu de France Teaching Hospital, Saint Joseph University, Beirut, Lebanon.
authors.forename: Tony
authors.initials: T
authors.lastname: Ibrahim
authors.affiliation: Internal Medicine Department, Saint Antoine Hospital, Pierre-et-Marie-Curie University, Paris, France. Electronic address: line_abdo@hotmail.com.
authors.forename: Lynn
authors.initials: L
authors.lastname: Abdo
mesh_terms: D003287:Contrast Media; D003937:Diagnosis, Differential; D004562:Electrocardiography; D004636:Emergency Service, Hospital; D005260:Female; D049671:History, 18th Century; D006801:Humans; D009203:Myocardial Infarction / Q000000981:diagnostic imaging* / Q000628:therapy; D015912:Thrombolytic Therapy; D014057:Tomography, X-Ray Computed
chemical_list: D003287:Contrast Media