Abstract
A 50-year-old man with a history of hypertension awakened with acute retrosternal chest pain accompanied by dim consciousness. He was transferred to cardiac catheterization laboratory for emergent percutaneous coronary intervention (PCI) but diagnostic coronary angiography was difficult and unsuccessful. Therefore, he was immediately conducted the thoracoabdominal computed tomography angiography (CTA). The CTA showed aortic dissection (Stanford type A), involving the left main coronary artery (LMCA) and left anterior descending (LAD). Emergency surgery was executed. Unfortunately, this patient eventually died of multiple organ dysfunction syndromes.
Highlights
Aortic dissection is known as a breach in the intima responsible for the creation of a neo-channel, which splits media between its third means and its third extern with the spontaneous mortality at 48 hours of 50% [1]
The rare clinical features can be presented as syncope with or without chest pain, renal failure, or as in this case, an acute myocardial infarction related to occlusion of the left main artery etc
The diagnosis of an acute Stanford type A aortic dissection remains a challenge for the emergency physician
Summary
Aortic dissection is known as a breach in the intima responsible for the creation of a neo-channel, which splits media between its third means and its third extern with the spontaneous mortality at 48 hours of 50% [1]. The typical patient presents with abrupt onset of chest pain, which is sharp (more often than constrictive), and moves toward the back if there is distal extension. The rare clinical features can be presented as syncope with or without chest pain, renal failure, or as in this case, an acute myocardial infarction related to occlusion of the left main artery etc. The diagnosis of an acute Stanford type A aortic dissection remains a challenge for the emergency physician
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