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An atypical case of acute myocardial infarction

Marc Laine1, Dominique Grisoli, Laurent Bonello

  • 1Hopital Universitaire Nord de Marseille, Marseille, France.

The Journal of Invasive Cardiology
|July 5, 2011
PubMed

Insights

Aortic dissection can cause ST-elevation myocardial infarction (STEMI) and cardiogenic shock due to left main coronary artery compression. This rare presentation highlights the need for aortic assessment in STEMI cases without typical atherothrombosis.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Emergency Medicine

Background:

  • ST-elevation myocardial infarction (STEMI) is commonly caused by atherothrombosis, treated with percutaneous coronary intervention.
  • Type-A aortic dissection is a life-threatening condition requiring emergent surgical repair.
  • Left main trunk (LMT) occlusion typically results from atherothrombosis.

Observation:

  • A patient presented with STEMI and cardiogenic shock.
  • The cause was identified as a type-A aortic dissection with a compressive hematoma affecting the left main coronary artery.

Findings:

  • This case highlights an unusual presentation of aortic dissection mimicking acute coronary syndrome.
  • Left main trunk occlusion due to non-atherosclerotic causes, such as aortic dissection, requires thorough aortic evaluation.

Implications:

  • Clinicians should consider aortic pathology in STEMI cases lacking typical atheromatous disease.
  • Prompt diagnosis and surgical management of aortic dissection are critical, as delays can lead to adverse outcomes like refractory cardiogenic shock.

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