An uncommon presentation of acute type A aortic dissection

Compostella, Leonida

doi:10.2459/jcm.0b013e328356a357

Cited by 2 publications

(1 citation statement)

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“…Other authorities are more specific, suggesting aortic imaging in either those with STEMI and symptoms suggestive of an aortic dissection, or all non-STEMI cases because dissection is statistically more likely to occur with nonspecific ECG changes [8]. However, as classic symptoms often do not occur, more individualized recommendations are for a multimodal imaging approach with CT and ECG to evaluate patients with dynamic ST abnormalities that are suspicious for intermittent coronary artery occlusions [30]. Our review further shows that patients with mycotic aortic aneurysms tend to have heightened leukocyte counts and markers of inflammation, both of which are easily and quickly obtained via point-ofcare testing and can help triage patients towards an infectious etiology.…”

Section: Conclusion and Recommendationsmentioning

confidence: 99%

Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction

Guo

Bonde

2015

Aorta

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Ruptured mycotic aneurysms occur infrequently in current clinical practice, and a pneumococcal etiology is even more rare. This case report describes a patient who initially presented with catheter lab activation for an acute ST-elevation myocardial infarction, receiving a full Plavix load. She was subsequently found to have a ruptured aortic aneurysm and underwent emergency surgical repair, with intraoperative findings of an aorta seeded with Streptococcus pneumonia. A retrospective evaluation of her history revealed clues of a previous upper respiratory infection and long-standing back pain. The subsequent literature review summarizes presentations and outcomes in previously reported, ruptured pneumococcal aneurysms and describes the relatively common occurrence of aortic conditions masquerading as acute myocardial infarctions. We provide recommendations to help approach similar situations in the future.

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Section: Conclusion and Recommendationsmentioning

confidence: 99%

Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction

Guo

Bonde

2015

Aorta

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ST Segment Elevation

Lucaci¹

2022

Romanian Journal of Cardiology

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As the earliest indirect sign of an acute coronary occlusion arriving against non-operative collateral heart vessels, the unabating ST segment elevation accounts for the acute coronary syndrome asking for mandatory and immediate reperfusion therapy. The geography of the ST segment elevations usually enables one to identify the culprit artery and to guess its likely occlusion site, as pivotal pieces of the necessary vital risk forecasting, along with somehow expected occurring arrhythmias. Aside from the classical ST segment elevation myocardial infarction (STEMI) pattern, a handful of distinctive non-ST elevation appearances of the acute coronary occlusion also need imperative reperfusion therapy, thus qualifying themselves as STEMI equivalents. The early forthcoming of ST elevation during an acute transmural ischaemic episode, as well as the wide availability of the electrocardiogram, make it an invaluable diagnostic tool. Yet many confounding factors are able to limit the diagnostic sensibility of ST elevation (as for example its customary absence in the conventional leads in some cases of circumflex artery occlusion, or the casual mutual cancellation of the transmural ST vectors from opposite ventricular walls), the accuracy of the electrocardiographic localisation of the occlusion site (due to coronary anatomic variants, concomitant new or old coronary lesions elsewhere, previous coronary artery bypass grafts), as well as its specificity for transmural ischaemia (by virtue of a well-known manifold of non-ischaemic causes). While the STEMI patient must be offered undelayed reperfusion therapy, the non-ischaemic ST elevation one should be kept away from the haemorrhagic risk of a useless invasive procedure.

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An uncommon presentation of acute type A aortic dissection

Cited by 2 publications

References 20 publications

Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction

Ruptured Pneumococcal Aortic Aneurysm Presenting as ST-Elevation Myocardial Infarction

ST Segment Elevation

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