Related Experiment Video

Updated: Mar 19, 2026

Acute Myocardial Infarction in Rats
07:45

Acute Myocardial Infarction in Rats

Published on: February 16, 2011

55.0K

Type A aortic dissection with transient myocardial ischemia caused by intimal flap inverting into the left ventricle

Akiko Ishige1, Hiroyuki Tanaka2, Tetsuro Ueda2

  • 1Department of Cardiology, Tokyo Metropolitan Fuchu Hospital (currently Tokyo Metropolitan Tama Medical Center), 2-8-29 Musashidai, Fuchu, Tokyo, 183-8524, Japan. aishigea@yahoo.co.jp.

Journal of Echocardiography
|June 10, 2016
PubMed

Insights

A rare case of type A aortic dissection caused transient myocardial ischemia by an intimal flap obstructing coronary artery flow, not root dissection. Transesophageal echocardiography (TEE) proved crucial for diagnosis.

Area of Science:

  • Cardiovascular Surgery
  • Cardiac Imaging
  • Thoracic Aortic Disease

Background:

  • Type A aortic dissection is a life-threatening condition often involving the aortic root.
  • Myocardial ischemia in aortic dissection typically results from coronary ostia involvement.
  • Accurate diagnosis is critical for timely surgical intervention.

Purpose of the Study:

  • To report a rare case of type A aortic dissection causing myocardial ischemia through a unique mechanism.
  • To highlight the diagnostic utility of transesophageal echocardiography (TEE) in complex aortic dissections.

Main Methods:

  • A 41-year-old male patient presented with chest oppression and ECG changes suggestive of ischemia.
  • Diagnosis of type A aortic dissection was confirmed.
  • Intraoperative transesophageal echocardiography (TEE) was performed to visualize aortic pathology.

Main Results:

  • The patient was diagnosed with type A aortic dissection, angina pectoris, and aortic regurgitation.
  • TEE revealed an intimal flap prolapsing into the left ventricle via the aortic valve.
  • Myocardial ischemia was attributed to the intimal flap intermittently covering the coronary ostia, not direct dissection extension.

Conclusions:

  • This case illustrates a rare etiology of myocardial ischemia in type A aortic dissection.
  • The dynamic movement of the intimal flap can obstruct coronary blood flow.
  • Transesophageal echocardiography is invaluable for elucidating complex mechanisms in aortic dissection.

Keywords:
Intimal flap inverting into the left ventricleTransient myocardial ischemiaTransthoracic echocardiogramType A aortic dissection

More Related Videos

A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery11:07

A Murine Model of Myocardial Ischemia-reperfusion Injury through Ligation of the Left Anterior Descending Artery

Published on: April 10, 2014

41.5K
Myocardial Infarction and Functional Outcome Assessment in Pigs12:03

Myocardial Infarction and Functional Outcome Assessment in Pigs

Published on: April 25, 2014

28.8K

Related Concept Videos

Aortic Regurgitation I: Introduction01:15

Aortic Regurgitation I: Introduction

IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
1.1K
Aortic Regurgitation II: Clinical Features and Diagnostic Tests01:22

Aortic Regurgitation II: Clinical Features and Diagnostic Tests

Aortic valve regurgitation (AR) occurs when the aortic valve fails to close properly, allowing blood to flow backward from the aorta into the left ventricle. This backflow can result in two distinct clinical presentations: acute and chronic AR, each characterized by its own set of symptoms and physical findings.Acute Aortic RegurgitationAcute AR presents with a sudden onset of severe symptoms. Patients typically experience profound dyspnea (shortness of breath), chest pain, and signs of left...
824
Aneurysm I: Introduction01:30

Aneurysm I: Introduction

An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
592
Mitral Stenosis I: Introduction01:22

Mitral Stenosis I: Introduction

Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
1.2K
Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
438
Mitral Valve Prolapse I: Introduction01:27

Mitral Valve Prolapse I: Introduction

IntroductionThe mitral valve, one of the heart's four valves, regulates blood flow. These valves have flaps that open and close to direct blood properly through the heart and body. During each heartbeat, the flaps open for blood to pass through and seal shut to prevent backflow. Specifically, the mitral valve opens to allow blood flow from the heart's upper left chamber to the lower left chamber. It then closes securely as the lower left chamber contracts to pump blood to the body, preventing...
866