Early detection of acute myocardial infarction by routine computed tomography of the chest: A case report

Evaluation of chest pain in the emergency department (ED) is a formidable challenge. It is established that multidetector computed tomography (MDCT) can detect the changes of myocardial perfusion after acute myocardial infarction (MI). However, there were few studies about MDCT changes before ECG and cardiac biomarkers confirmed acute myocardial infarction. We report a case presented to the ED with sharp chest pain. MDCT performed for suspected aortic dissection showed decrease myocardial enhancement, suggestive of acute MI before ECG changes and rises of cardiac enzymes, but no evidence of aortic dissection. Acute myocardial infarction was subsequently confirmed by both the ECG changes and increased levels of cardiac biomarkers.