Chest CT can be first step to identifying if patient has had a heart attack

When radiologists are looking at contrast-enhanced chest CT examinations, they should take a look at the patient's heart to rule out heart attack, regardless of why the chest CT examination is being performed, a new study shows.

The study included 59 patients who had undergone chest CT examinations; none of the examinations were ordered specifically to look at the heart, said Linda Haramati, MD, professor of clinical radiology at Albert Einstein College of Medicine and one of the authors of the study. Previous studies, not performed in a clinical setting, had indicated that normal heart muscle enhances (shows up brighter on the CT image) when contrast enhanced CT is performed, said Dr. Haramati. This proved true in the clinical setting; the one patient who had had a recent heart attack showed reduced enhancement on the CT examination, she said. The CT examination must be correlated with medical records and other cardiac tests to confirm a recent heart attack, because there are false positives with the CT examination, said Dr. Haramati. The CT examination had indicated myocardial infarction in six of the 59 patients; five of them had not had a heart attack.

This study shows that if a patient is having a chest CT, it is appropriate for the radiologist to look for decreased enhancement of the heart as a first step to identifying if the patient has had a heart attack, she said. The use of contrast-enhanced CT to correctly identify heart attack needs to be studied further, she added.

The study was presented at the American Roentgen Ray Society Annual Meeting in New Orleans, LA.