Open AccessThe central role of CT coronary angiography in postcardiac arrest care in the young adult
Author(s) -
Ayisha Mehtab Khan-Kheil,
Alexandra Moss,
Leanne Stephens,
Jamal Khan
Publication year - 2019
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-232104
Subject(s) - medicine , cardiology , ventricular fibrillation , coronary artery disease , sudden cardiac arrest , coronary angiography , return of spontaneous circulation , sudden cardiac death , resuscitation , radiology , interventional cardiology , cardiopulmonary resuscitation , myocardial infarction , surgery
A 32-year-old man with no medical history went into ventricular fibrillation while running at the gym. He was transferred to our tertiary centre post successful resuscitation where admission electrocardiography and echocardiography were unremarkable. The initial cause of cardiac arrest was suspected arrhythmogenic and he was admitted for further investigations including exercise testing, ajmaline challenge, CT coronary angiography (CTCA) and cardiovascular MRI, with the likely outcome of cardioverter-defibrillator implantation. CTCA, however, revealed significant stenosis in the proximal left anterior descending artery as the likely cause for his arrest. Invasive coronary angiography confirmed this and facilitated successful stent implantation, avoiding the need for implantable cardioverter-defibrillator implantation. This case highlights the importance of CTCA, a non-invasive and readily-available test in the investigation of young patients postcardiac arrest, who require active exclusion of coronary artery disease and anomalous coronary anatomy, though they represent a low-risk population group.