Related Experiment Video

Updated: Feb 27, 2026

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots
12:17

Full-root Aortic Valve Replacement by Stentless Aortic Xenografts in Patients with Small Aortic Roots

Published on: May 21, 2017

11.9K

Critical aortic stenosis presenting as STEMI

Ying X Gue1, Sanjay S Bhandari2, Damian J Kelly2

  • 1Department of Cardiology, Royal Derby Hospital, Derby Hospital NHS Foundation Trust, Derby, UK y.gue@nhs.net.

Echo Research and Practice
|July 8, 2017
PubMed

Insights

Critical aortic stenosis (AS) can rarely present as ST-segment elevation myocardial infarction (STEMI). Prompt echocardiography is vital for diagnosing AS in STEMI patients, guiding appropriate treatment like aortic valve replacement.

Area of Science:

  • Cardiology
  • Geriatric Medicine
  • Diagnostic Imaging

Background:

  • Aortic stenosis (AS) is a common valvular heart disease in the elderly, affecting 2-9% of individuals over 65.
  • AS can lead to myocardial ischemia through abnormal cardiac-coronary coupling, mimicking acute coronary syndromes.
  • ST-segment elevation myocardial infarction (STEMI) typically indicates occlusive coronary artery disease requiring urgent intervention.

Observation:

  • A 73-year-old male presented with chest pain and inferior ST elevation on ECG, suggestive of STEMI.
  • Coronary angiography revealed no obstructive lesions to explain the ECG changes and symptoms.
  • Bedside echocardiography identified critical aortic stenosis as the underlying cause.

Findings:

  • The patient's symptoms and ECG changes resolved following intra-aortic balloon pump (IABP) insertion.
  • Successful aortic valve (AV) replacement was performed, obviating the need for coronary intervention.
  • This case highlights a rare presentation of critical AS mimicking STEMI.

Implications:

  • A focused clinical examination, including auscultation for murmurs, is crucial in STEMI patients before invasive procedures.
  • Echocardiography should be considered in STEMI cases without clear coronary culprits to rule out alternative diagnoses like AS.
  • Prompt diagnosis and management of AS can prevent unnecessary coronary interventions and improve patient outcomes.

Keywords:
aortic stenosisechocardiogrammyocardial infarction

More Related Videos

Precision Ultrasound-guided Stem Cell Delivery for Vascular Repair in Aortic Diseases04:59

Precision Ultrasound-guided Stem Cell Delivery for Vascular Repair in Aortic Diseases

Published on: June 20, 2025

842
Novel and Innovative Hybrid Technique for Type A Aortic Dissection06:26

Novel and Innovative Hybrid Technique for Type A Aortic Dissection

Published on: March 28, 2025

1.1K

Related Concept Videos

Acute Coronary Syndrome I: Introduction01:30

Acute Coronary Syndrome I: Introduction

Acute Coronary Syndrome (ACS) encompasses a spectrum of heart conditions caused by sudden obstruction of coronary arteries, typically resulting from the rupture of an atherosclerotic plaque and subsequent thrombus (blood clot) formation. This obstruction can lead to partial or complete blockage of blood flow, causing varying degrees of myocardial ischemia or infarction.ACS includes the following clinical entities:Unstable Angina (UA)Non-ST-Elevation Myocardial Infarction (NSTEMI)ST-Elevation...
1.2K
Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations01:19

Acute Coronary Syndrome II: Pathophysiology and Clinical Manifestations

The pathophysiology of Acute Coronary Syndrome [ACD] involves several key processes:The main underlying cause of ACD is atherosclerosis, a chronic inflammatory disease characterized by the buildup of lipid-laden plaques within the coronary arteries.As the atherosclerotic plaque grows in the coronary artery, it may become unstable due to the formation of a lipid-rich core and a thin fibrous cap. Inflammatory cells within the plaque, such as macrophages, secrete enzymes that degrade the...
535
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...
680
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...
874
Mitral Stenosis II: Clinical features and Diagnostic Tests01:23

Mitral Stenosis II: Clinical features and Diagnostic Tests

Mitral stenosis is a heart condition in which the mitral valve, which allows blood to flow from the left atrium to the left ventricle, becomes narrowed or stenotic. This narrowing hinders blood flow and leads to clinical symptoms requiring specific medical evaluations and management strategies. The following overview outlines the clinical symptoms, assessments, diagnostic findings, prevention methods, and treatments for mitral stenosis.Clinical ManifestationsDyspnea (shortness of breath): This...
344
Acute Coronary Syndrome III: Diagnostic Studies01:30

Acute Coronary Syndrome III: Diagnostic Studies

Diagnosing acute coronary syndrome or ACS begins with a thorough patient history. Notable symptoms include central, crushing chest pain radiating to the left arm, neck, jaw, or back, along with shortness of breath, sweating (diaphoresis), nausea, vomiting, dizziness, and palpitations.It is crucial to note any history of cardiac illnesses and assess risk factors, including age, gender, smoking, hypertension, diabetes, hyperlipidemia, and a sedentary lifestyle.During physical examination, vital...
334