[Coronary insufficiency in type II aortic dissection]

After coronary sclerosis, aortic dissection represents an important differential diagnosis in the evaluation of acute thoracic pain. We report on a 55-year-old patient with aortic dissection, type II, in whom the diastolic collapse of the true aortic lumen was verified by angiography and transesophageal echocardiography. The collapse led to a temporary perfusion deficit of the left coronary artery with clinical symptoms and ECG changes. Clinical symptoms, additional diagnostic procedures and follow-up of this patient, as well as the value of transesophageal echocardiography, are presented.