Do we need cardiovascular computed tomography angiography in the setting of acute ST-segment elevation myocardial infarction?

While the role of cardiovascular computed tomography angiography (CCTA) is evolving in low-intermediate risk patients with myocardial injury due to equivocal causes, this report highlights the added value of CCTA in evaluating the mechanism of acute ST-segment elevation myocardial infarction in a pa...

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Bibliographic Details
Published in:The International Journal of Cardiovascular Imaging 2022-02, Vol.38 (2), p.423-425
Main Authors: Mansour, Mohamad Jihad, Mansour, Layal, Bénic, Clément, Mansourati, Jacques, Gilard, Martine
Format: Article
Language:English
Subjects:
Angiography
Aorta
Aortic dissection
Aortic valve
Cardiac Imaging
Cardiology
Chest
Computed tomography
Computed Tomography Angiography
Coronary Angiography - methods
Coronary artery
Dissection
Drug delivery
Drug-Eluting Stents
Etiology
Health risks
Heart attacks
Heart valves
Humans
Images in CV Applications
Imaging
Implants
Ischemia
Male
Medical imaging
Medicine
Medicine & Public Health
Middle Aged
Myocardial infarction
Pain
Percutaneous Coronary Intervention - methods
Predictive Value of Tests
Radiology
Segments
ST Elevation Myocardial Infarction - diagnostic imaging
ST Elevation Myocardial Infarction - therapy
Stents
Thrombosis
Tomography
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Summary:While the role of cardiovascular computed tomography angiography (CCTA) is evolving in low-intermediate risk patients with myocardial injury due to equivocal causes, this report highlights the added value of CCTA in evaluating the mechanism of acute ST-segment elevation myocardial infarction in a patient with aortic dissection and mechanical aortic valve replacement. CCTA provided accurate diagnosis and guided therapy without delay. A 51-year-old man with mechanical aortic valve replacement was admitted for severe chest pain. CCTA showed type A aortic dissection with an entry tear at the ostial left main coronary artery. Given the high surgical risk, he underwent fenestration of the false lumen. Twelve days postoperatively, he had chest pain with anterior STEMI. Urgent CCTA showed two left coronary thrombi with transmural extensive ischemia. Urgent thrombus aspiration and percutaneous coronary intervention were performed. A drug-eluting stent was placed on the proximal LAD. CCTA was crucial prior to PCI in order to define the etiology of STEMI and evaluate the vascular access.
ISSN:1569-5794
1573-0743
1875-8312
DOI:10.1007/s10554-021-02397-8