Presentation
Persistent abdominal pain after eating a "huge stack of pancakes" for breakfast.
Patient Data
Hypoattenuation of the left ventricular myocardium in a subendocardial distribution of the left anterior descending coronary artery concerning acute myocardial infarction.
Nonobstructing punctate right renal stone. Simple cyst within the right kidney with additional bilateral subcentimeter renal hypodensities which are too small to characterize.
Hazy perihilar opacities and Kerley B lines likely represent mild pulmonary edema.
Case Discussion
This case shows that the clinical presentation of myocardial infarction may be misleading and that patients may present with abdominal pain. It's important to evaluate the heart on CT scans whenever the heart is included in a scan. In this case, subendocardial hypoattenuation in the cardiac apex and septum was consistent with decreased perfusion in the distribution of the left anterior descending artery.
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