The emergency physician confirmed EKG changes and elevated troponin levels compatible with acute myocardial infarction. 

This case shows the importance of analyzing all parts of an exam in a systematic way, looking not only at what the clinicians request to rule in or out. Similarly, very few CT exams to rule out pulmonary embolism in Western countries are actually positive for pulmonary embolism, warranting a careful search for alternative pathology to explain patient symptoms.

Another important point is that, even on non-EKG-gated scans, several cardiac pathologies can be suggested.