Type A Aortic Dissection Masquerading as an Inferior Myocardial Infarction

Abstract

Type A aortic dissection is a life-threatening condition with a wide range of clinical manifestations. Dissection can sometimes mimic an acute myocardial infarction due to similar presenting symptoms and initial clinical investigations. We report the case of a 52-year-old male who presented with an inferior ST-segment elevation myocardial infarction with two drug-eluting stents inserted as a stabilizing intervention prior to surgical repair of an acute aortic dissection.

A Rare Pathology Masquerading as Myocardial Infarction

“…Type A aortic dissection manifesting as acute myocardial infarction is relatively rare but could have catastrophic consequences due to delayed recognition. 1 In patients with persistent ST-segment elevation and are candidates for reperfusion therapy (either pharmacological or catheter-based), the recommendation is to restore coronary flow promptly in the occluded infarct related artery. The delay from patient contact with the healthcare system to balloon inflation [door to balloon] should be less than 90 minutes (Class 1, level of evidence: B).…”

Case report: Surgery combined with extracorporeal membrane oxygenation for a patient with type A aortic dissection complicated with myocardial infarction after percutaneous coronary intervention

“…Hypoperfusion of the aortic branches caused by dissection of the false lumen can occur in all branches from the coronary artery opening to the abdominal aortic bifurcation (1). If the coronary artery is affected by acute type A AD, AMI may be the primary manifestation, and AD may be diagnosed late or go undetected if not fully considered (2).…”