Aetiology of cardiac arrest in a ‘trauma patient’: Exploiting trauma CT for concomitant cardiac assessment

The widespread use of protocolised CT in trauma has the potential to expedite assessment and save lives. However, the exclusion of injury may risk overlooking other important pathology, where patients have been involved in potentially traumatic incidents because of an underlying medical problem. This case describes a middle-aged patient who suffered an out-of-hospital cardiac arrest while driving his car. Some days after admission he was found to have an occluded left anterior descending coronary artery, which had been poorly visualised on his trauma CT. The difficulties in identifying coronary occlusion in the critically ill patient are considered, and the utility of ECG-gated CT for cardiac evaluation and its potential impact on rapid diagnosis in trauma is discussed.