LAD occlusion and cardiac apex infarction

Case contributed by Stefan Tigges
Diagnosis certain

Presentation

Chest pain and shortness of breath.

Patient Data

Age: 50 years
Gender: Male
This study is a stack
Axial lung
window
This study is a stack
Axial
C+ CTPA
This study is a stack
Coronal
lung window
This study is a stack
Coronal
C+ CTPA
This study is a stack
Sagittal
C+ CTPA
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Info

No pulmonary embolism, aorta normal in course and calibre. Hypoperfusion cardiac apex with small apical thrombus suggests ischaemia in the distribution of the left anterior descending coronary artery. Small pericardial effusion, mildly enhancing pericardium, small left pleural effusion. Mild perihilar oedema.

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Info

Complete occlusion left anterior descending coronary artery just distal to its origin.

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Info

Support apparatus appropriately positioned, bilateral perihilar oedema.

Case Discussion

Good illustration of the necessity of evaluating the myocardium in patients who are referred for CTPA to rule out pulmonary embolism.

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