Vesela Stoynova, Sofia, Bulgaria has sent the following question: Cardiac CT: Hi EXPERTS, We do a lot of cardio CT with 16 slice GE. We are on the way to by a new CT. I have read all advertisement about DSCT. I would like to hear your oppinion on  ustabile heart rate, extrasystole … Read more

Please, click on the title to see the protocol. Read more

Case history Five years following quadruple CABG surgery, this 64-year-old patient started experiencing atypical chest pain. Question Are any of the bypass grafts or anastomoses stenotic or occluded? Is there an extra-cardiac cause behind the patient‘s symptoms? Diagnosis/Differential diagnosis Acute graft thrombosis, myocardial infarction, myocardial ischemia due to graft stenosis, aortic dissection, pulmonary embolism, pericarditis, … Read more

Case history This 67-year-old patient post CABG was admitted due to recurrent chest pain following microcoil embolization of his saphenous venous graft pseudoaneurysm performed at another institution. Question What is the cause of … Read more

Case history 49-year-old patient with atypical chest pain and an equivocal bicycle stress test (non-significant ST segment depression in the anterior leads). Question The relative young age of the patient, atypical nature of the chest pain, and equivocal stress test make coronary artery disease rather unlikely. Thus, coronary CTA was performed to rule … Read more

Case history 43-year-old patient with acute chest pain, not entirely typical for myocardial infarction. ST segment elevation [fig. 1] and enzyme elevation. Echo was normal. Question Myocarditis versus myocardial infarction: Can coronary stenoses/occlusions be ruled out? Diagnosis / Differential diagnosis Chest pain and ST segment elevation are the lead symptoms of acute myocardial infarction. Here, … Read more

Case history A 50-year-old male with known coronary artery disease presents with acute chest pain two weeks after stenting of the left anterior descending coronary artery. Question Is the stent occluded? Is there a restenosis or another coronary artery stenosis? Is there another cause of chest pain? Diagnosis / Differential diagnosis The differential diagnoses in … Read more