Approach to Imaging of Patients Presenting With Acute Coronary Syndrome With No Culprit Lesion Identified at Angiography

J Thorac Imaging. 2024 Mar 1;39(2):69-78. doi: 10.1097/RTI.0000000000000773. Epub 2024 Jan 19.

Abstract

Chest pain is a common chief complaint among patients presenting to the emergency department. However, in the scenario where the clinical presentation is consistent with acute coronary syndrome and no culprit lesions are identified on angiography, clinicians and cardiac imagers should be informed of the differential diagnosis and appropriate imaging modalities used to investigate the potential causes. This review describes an imaging-based algorithm that highlights the diagnostic possibilities, their differentiating imaging features, and the important role of cardiovascular magnetic resonance imaging for narrowing the differential diagnosis.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome* / complications
  • Acute Coronary Syndrome* / diagnostic imaging
  • Chest Pain / diagnostic imaging
  • Chest Pain / etiology
  • Coronary Angiography
  • Emergency Service, Hospital
  • Humans
  • Magnetic Resonance Imaging / methods