Abstract
Acute Type I aortic dissections are fast progressing highly mortal vascular emergencies if management delays. In this particular paper we report a case with a Type I aortic dissection mistreated for first 2 hours as thrombotic AMI, and aortic dissection diagnosis confirmed and treated surgically immediately. 59 years old male patient admitted to emergency room with sudden onset chest pain. Patient was seen by cardiologist and with NSTMI diagnosis admitted to Coronary ICU. With the suspicion of aortic dissection patient was scanned with contrasted thoraco-abdominal CT. Exam revealed subtotal occlusion of ascending aorta by flap of De Bakey Type I aortic dissection. In conclusion aortic dissection should be considered in differential diagnosis of chest pain. Clinical suspicion aortic dissection is key point of diagnosis and immediate confirmation may be life saving.
Highlights
Acute Type I aortic dissections are fast progressing highly mortal vascular emergencies if management delays. In this particular paper we report a case with a Type I aortic dissection mistreated for first 2 hours as thrombotic AMI, and aortic dissection diagnosis confirmed and treated surgically immediately. 59 years old male patient admitted to emergency room with sudden onset chest pain
In conclusion aortic dissection should be considered in differential diagnosis of chest pain
Acute type I aortic dissection is a vascular emergency— because needs rapid diagnosis and management that should be focused by cardiologists, thoracic and vascular surgeons
Summary
Acute Type I aortic dissections are fast progressing highly mortal vascular emergencies if management delays. Medial degenerasyon (cystic medial necrosis), marfan, turner, noonan and ehlers-danlos syndrome, bicuspid aortic valve, dilated ascending aorta (greater than 5.0 to 5.5 cm), atherosclerosis, aortic coarctation, systemic arterial hypertension, closed chest trauma, pregnancy, aortic cannulation, and intramural hematoma are associated with aortic dissection [2,3]. Aortic dissection may cause to AMI (Acute myocardial Infarction) in 1% - 3% frequency [4]. Management of AMI subsequent to dissection differs from thrombotic AMI. In this particular paper we report a case with a Type I aortic dissection mistreated for first 2 hours as thrombotic AMI, and aortic dissection diagnosis confirmed and treated surgically immediately
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