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Acute myocardial infarction due to an acute type A aortic dissection involving the left main coronary artery

E S Zegers1, H R Gehlmann, F W A Verheugt

  • 1Department of Cardiology, Radboud University Nijmegen Medical Centre, Nijmegen, the Netherlands.

Netherlands Heart Journal : Monthly Journal of the Netherlands Society of Cardiology and the Netherlands Heart Foundation
|October 10, 2007
PubMed

Insights

An uncommon cause of heart attack is Stanford type A aortic dissection extending into the coronary artery. This case highlights spontaneous dissection involving the aorta and coronary artery, requiring emergent surgery.

Area of Science:

  • Cardiovascular Medicine
  • Thoracic Surgery
  • Interventional Cardiology

Background:

  • Stanford type A aortic dissection can rarely involve coronary arteries, leading to myocardial infarction.
  • Spontaneous aortic dissection, particularly involving the Valsalva sinus and ascending aorta, presents a significant clinical challenge.

Purpose of the Study:

  • To report a rare case of anterior myocardial infarction secondary to Stanford type A aortic dissection involving the left main coronary artery.
  • To discuss the pathophysiology and management of aortocoronary dissection in the context of aortic dissection.

Main Methods:

  • Case report detailing a patient with spontaneous aortic dissection.
  • Review of clinical presentation, diagnostic findings, and surgical intervention.

Main Results:

  • The patient presented with anterior myocardial infarction attributed to dissection extending into the left main coronary artery.
  • Successful surgical management involved emergent aortic replacement and coronary revascularization.

Conclusions:

  • Acute myocardial infarction from aortic dissection extension is infrequent but critical.
  • Spontaneous aortocoronary dissection, linked to hypertension, necessitates prompt surgical intervention.

Keywords:
aortacoronary artery (left main)dissectionmyocardial infarction

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