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

Z Y Wang1, Y J Wang2, X L Liu3

  • 1Department of Cardiology, China-Japan Union Hospital of Jilin University, Changchun, P.R. China

Journal of Biological Regulators and Homeostatic Agents
|September 29, 2017
PubMed

Insights

Acute chest pain can stem from aortic dissection or acute myocardial infarction (AMI), demanding rapid diagnosis. This case highlights the risk of misdiagnosing type A aortic dissection (AAD) as NSTEMI, emphasizing comprehensive data review for accurate diagnosis and timely treatment.

Area of Science:

  • Cardiology
  • Vascular Surgery

Background:

  • Acute chest pain is a critical medical emergency requiring prompt differential diagnosis between aortic dissection and acute myocardial infarction (AMI).
  • Both conditions share similar symptoms, posing diagnostic challenges and potentially leading to delayed treatment.
  • Type A aortic dissection (AAD) and NSTEMI can present with overlapping clinical and electrocardiogram (ECG) findings.

Observation:

  • A patient presenting with acute chest pain and ECG changes suggestive of non-ST-segment elevation myocardial infarction (NSTEMI) was initially misdiagnosed.
  • Diagnostic workup, including coronary angiography, ultimately revealed type A aortic dissection (AAD).

Findings:

  • The case underscores the potential for misdiagnosis of AAD as NSTEMI due to similar presenting symptoms.
  • Accurate and timely diagnosis is crucial for effective management and improved patient outcomes in cases of acute chest pain.

Implications:

  • Clinicians must consider AAD in the differential diagnosis of acute chest pain, even with ECG findings typical of NSTEMI.
  • Thorough patient data collection, including medical history and auxiliary examination results, is essential to avoid misdiagnosis and treatment delays.
  • Early and accurate diagnosis of AAD can significantly reduce mortality rates in patients presenting with chest pain and NSTEMI-like ECG patterns.

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