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[Acute myocardial infarction due to an acute aortic dissection]

C Stefanidis1, A Sanoussi, H Demanet

  • 1Services de Chirurgie Cardiaque, C.H.U. Brugmann. constantin.stefanidis@chu-brugmann.be

Revue Medicale De Bruxelles
|August 13, 2011
PubMed

Insights

Myocardial infarction can mask aortic dissection. Initial treatment for myocardial infarction, including anticoagulation, should not be altered even if emergent surgery is needed.

Area of Science:

  • Cardiology
  • Cardiovascular Surgery
  • Medical Diagnostics

Background:

  • Myocardial ischemia from ascending aortic dissection is rare.
  • A 76-year-old man presented with chest pain mimicking acute myocardial infarction.

Purpose of the Study:

  • To highlight the diagnostic challenge of aortic dissection presenting as myocardial infarction.
  • To emphasize the importance of considering aortic dissection in myocardial infarction cases.

Main Methods:

  • Case report of a 76-year-old male with sudden chest pain.
  • Electrocardiogram (ECG) and coronary angiography were performed.
  • Computed tomography (CT) confirmed type A aortic dissection.

Main Results:

  • ECG suggested inferior wall acute myocardial infarction.
  • Coronary angiography revealed anomalous right coronary artery origin and extrinsic stenosis.
  • CT confirmed type A aortic dissection extending to the right coronary artery.

Conclusions:

  • Myocardial infarction can obscure the diagnosis of aortic dissection.
  • Initial myocardial infarction treatment, including anticoagulation, should be maintained for emergent cardiac surgery.
  • This approach may increase postoperative bleeding but is crucial for patient survival.

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