title: Cardiac CT angiography in the emergency room: Apical hypertrophic cardiomyopathy presenting as acute coronary syndrome.
abstract: A 59-year-old male presented to the emergency room with symptoms of chest tightness and palpitations. Following conversion of atrial fibrillation to sinus rhythm, he had deep symmetrical T-wave changes on his electrocardiogram. Symptoms resolved almost immediately, and his initial troponin was negative. He underwent cardiac CT angiography utilizing an emergency room triage protocol which resulted in a diagnosis of nonobstructive coronary artery disease and apical hypertrophic cardiomyopathy. Following a hospital stay of less than 24 hours, he was discharged to outpatient follow-up on medical management and has remained asymptomatic over 6 months. This case presentation illustrates an example of the diversity of pathology that presents in emergency rooms with symptoms consistent with acute coronary syndrome.
authors.affiliation: Cardiovascular Specialists of Southwest Louisiana, Lake Charles, LA, USA.
authors.forename: Michael C
authors.identifier: http://orcid.org/0000-0001-9452-9500
authors.initials: MC
authors.lastname: Turner
authors.affiliation: Heart Clinic of Louisiana, Marrero, LA, USA.
authors.forename: Edmund K
authors.initials: EK
authors.lastname: Kerut
authors.affiliation: East Jefferson General Hospital, Metairie, LA, USA.
authors.forename: James
authors.initials: J
authors.lastname: Mckinnie
authors.affiliation: Christus St. Patrick Hospital, Lake Charles, LA, USA.
authors.forename: Michael
authors.initials: M
authors.lastname: Davis
authors.affiliation: Cardiovascular Specialists of Southwest Louisiana, Lake Charles, LA, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Hinton
mesh_terms: D054058:Acute Coronary Syndrome / Q000000981:diagnostic imaging*; D002312:Cardiomyopathy, Hypertrophic / Q000150:complications / Q000000981:diagnostic imaging*; D000072226:Computed Tomography Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D008875:Middle Aged
keywords: apical hypertrophic cardiomyopathy; chest pain; computed tomography