Myocardial infarct (anterior)

Case contributed by Dr Yi-Jin Kuok

Presentation

Drunk patient presenzed with chest pain. Aortic dissection was suspected by the clinician.

Patient Data

Age: 25 years
Gender: Male

Lung windows demonstrate ground glass infiltrate with smooth interlobular septal thickening and peribronchial cuffing consistent with early heart failure.

Soft tissue windows demonstrate reduced first pass of contrast into the anterior left ventricular wall correlating to the territory of the left anterior descending artery.

Incidental fatty thymus, common finding in young adults

Incidental azygous fissure

Coronary angiogram report

Photo

Subsequent coronary angiogram showed the proximal left anterior descending artery to be completely occluded.

Case Discussion

Although CT of the chest is not a routine modality for the diagnosis of myocardial infarction, it should be noted that with modern scanners it is possible to see infarcted myocardium. In patients with unusual / atypical presentations, an AMI may not be suspected clinically. 

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