Cardiac enzymes after two hours are borderline elevated. C-Troponin is 98.5% of the normal range. The clinician ponders if perhaps the origin of the troponin elevation is from the epicardium or the pleura.
Physician is at the bedside. She next considers pulmonary embolism; meanwhile she requests a cardiologist consultation. She orders a chest-computed tomogram (CAT scan) with contrast media to search for embolism. The results of the CT scan adjusted to an early phase of contrast view are reported as negative for pulmonary embolism, but the ascending aorta was reported to be prominent, measuring 4.3 cm in diameter (normal aortic is 3.63 to 3.91 cm).