Hospital Practices and Research

Abstract Non-cardiac CT angiograms may be helpful when searching for the etiology of cardiac arrest in out-of-hospital cardiac arrest cases and may be effective in the decision of early percutaneous coronary intervention. We want to share an experience related to this topic. A 51-year-old male patient returned home after travelling by plane from abroad and suddenly collapsed while hugging his relatives at home, followed by cardiac arrest (CPA). CTA showed no obvious pathology in the aorta and pulmonary artery, but the proximal left anterior descending artery (LAD) branching from the left main coronary artery (LMCA) was not contrast enhanced and was thought to be an occluded lesion. The cardiology unit was contacted and the patient was taken to the emergency coronary angiography unit. Coronary angiography revealed a critical stenosis in the proximal LAD. In this case, the patient's heart rate was not suitable for a coronary CT angiography (90 beats/minute), and the option of slowing the heart down was not an option as the patient was unstable and had ROSC after CPA. In addition, no radiologic editing of the images for artifacts due to heart rate was performed. Thoracic aorta angiography is not a standard imaging method for coronary artery lesions. However, in this case, it raised suspicion of coronary artery occlusion and was indicative of an occlusion that could not be detected on ECG.