Could contrast-enhanced CT detect STEMI prior to electrocardiogram?

      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.
      To read this article in full you will need to make a payment
      One-time access price info
      • For academic or personal research use, select 'Academic and Personal'
      • For corporate R&D use, select 'Corporate R&D Professionals'


      Subscribe to The American Journal of Emergency Medicine
      Already a print subscriber? Claim online access
      Already an online subscriber? Sign in
      Institutional Access: Sign in to ScienceDirect


      1. Hollander JE, Chase M. Evaluation of chest pain in the emergency department. In: UpToDate, Post TW (Ed), UpToDate, Waltham, MA. (Accessed on May 07, 2013).

        • Goodacre S.
        • Thokala P.
        • Carroll C.
        • Stevens J.W.
        • Leaviss J.
        • Al Khalaf M.
        • et al.
        Systematic review, meta-analysis and economic modelling of diagnostic strategies for suspected acute coronary syndrome.
        Health Technol Assess. 2013; 17: 1-18
        • Gosalia A.
        • Haramati L.B.
        • Sheth M.P.
        • Spindola-Franco H.
        CT detection of acute myocardial infarction.
        AJR Am J Roentgenol. 2004; 182: 1563-1566
        • Panagiotidis E.
        • Price G.
        • Harland S.
        • Bomanji J.
        • Kayani I.
        Myocardial uptake of 99mTc-HDP and reduced perfusion on CT in subacute myocardial infarction.
        Clin Nucl Med. 2014; 39: 117-120
        • Arnett J.H.
        • Mohajer K.
        • Okon S.A.
        Evidence of acute myocardial infarction on CT.
        Br J Radiol. 2007; 80: 219-221
        • Ichinose T.
        • Yamase M.
        • Yokomatsu Y.
        • Kawano Y.
        • Konishi H.
        • Tanimoto K.
        • et al.
        Acute myocardial infarction with myocardial perfusion defect detected by contrast-enhanced computed tomography.
        Intern Med. 2009; 48: 1235-1238
        • Veselova T.N.
        • Ternovoĭ S.K.
        Informative value of multislice spiral computed tomography in identifying myocardial perfusion defect in patients with acute myocardial infarction.
        Ter Arkh. 2013; 85: 16-21