An uncommon presentation of acute type A aortic dissection: left main coronary artery obstruction

作者：Courand Pierre Yves^*; Dauphin Raphael; Roussel Eric; Besnard Cyril; Lantelme Pierre

来源：Journal of Cardiovascular Medicine, 2012, 13(1): 53-55.

DOI：10.2459/JCM.0b013e328348c390

• aVR ST-segment elevation
• left main coronary artery
• myocardial infarction
• Stanford type A aortic dissection

Acute aortic dissection presents with a wide range of manifestations. Sometimes an acute coronary syndrome is diagnosed instead of aortic dissection leading to inappropriate treatment. We describe a case of acute aortic dissection with the uncommon involvement of the left main coronary artery. A 64-year-old man was referred to our hospital for primary coronary intervention because ECG demonstrated ST elevation in the aVR lead with diffuse ST-segment depression. Coronary angiography was performed to treat the culprit lesion but the left main coronary artery could not be catheterized. Aortography and transesophageal echocardiography confirmed Stanford type A aortic dissection. The patient died of cardiac arrest in spite of cardiopulmonary resuscitation. This case also illustrates how Stanford type A aortic dissection can present with left main coronary artery obstruction.

• 出版日期2012-1