Aortic dissection with acute non-st-segment elevation myocardial infarction as the first manifestation

Acute chest pain caused by aortic dissection or acute myocardial infarction (AMI) is one of the most serious medical emergencies and requires very quick differential diagnosis to seize the best time for treatment. Aortic dissection and acute myocardial infarction are manifested with similar symptoms, making it difficult to differentially diagnose these two conditions. The present case was initially misdiagnosed as an acute non-ST-segment elevation myocardial infarction (NSTEMI) with left aortic disease, and then diagnosed by coronary angiography examination as type A aortic dissection (AAD). This case points to the need to collect and analyze as much patient clinical data as possible, including medical history and the results of auxiliary examination which would help to avoid misdiagnosis or treatment delay and reduce mortality among patients with type AAD when they manifest symptoms of chest pain and an ECG pattern of NSTEMI.