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A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis
18:11

A Research Method For Detecting Transient Myocardial Ischemia In Patients With Suspected Acute Coronary Syndrome Using Continuous ST-segment Analysis

Published on: December 28, 2012

Cath-Lab Clues to Type A Aortic Dissection Presenting as Acute Myocardial Infarction

Yingdong Wang1, Yuhe Sheng2, Yaling Han2

  • 1Department of Cardiology, General Hospital of Northern Theater Command, Shenyang, Liaoning, China; Lanzhou University, Lanzhou, Gansu, China.

JACC. Case Reports
|August 22, 2026
PubMed

Insights

Recognize 5 catheterization laboratory clues for type A aortic dissection to avoid misdiagnosis of acute myocardial infarction. Prompt recognition and pausing intervention can prevent harm and ensure appropriate aortic surgical team activation.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • Type A aortic dissection can mimic acute myocardial infarction.
  • Catheterization laboratory findings may indicate aortic dissection but are often overlooked.

Purpose of the Study:

  • To identify and summarize key catheterization laboratory clues for type A aortic dissection.
  • To prevent misdiagnosis and unnecessary interventions in patients with suspected myocardial infarction.

Main Methods:

  • Retrospective analysis of a case presenting with ST-elevation myocardial infarction.
  • Review of coronary angiography and computed tomography angiography findings.
  • Identification of recurring angiographic signs suggestive of aortic dissection.

Main Results:

  • A 67-year-old man with suspected myocardial infarction showed difficult coronary engagement, left coronary narrowing, and catheter swing during angiography.
  • Computed tomography angiography confirmed type A aortic dissection involving the left main ostium.
  • Five specific angiographic clues were identified.

Conclusions:

  • These 5 catheterization laboratory clues can help differentiate aortic dissection from myocardial infarction.
  • Timely recognition and pausing procedures are crucial.
  • Activation of the aortic surgical team is essential for appropriate management.
Abstract

Keywords:
acute myocardial infarctionacute type A aortic dissectioncoronary angiographycoronary malperfusionpercutaneous coronary intervention

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