scholarly journals Acute Aortic Dissection Mimicking STEMI in the Catheterization Laboratory: Early Recognition Is Mandatory

2012 ◽  
Vol 2012 ◽  
pp. 1-3
Author(s):  
Alessio Arrivi ◽  
Gaetano Tanzilli ◽  
Paolo Emilio Puddu ◽  
Giovanni Truscelli ◽  
Marcello Dominici ◽  
...  

Coronary malperfusion due to type A aortic dissection is a life-threatening condition where timely recognition and treatment are mandatory. A 77-year-old woman underwent an acute evolving type A aortic dissection mimicking acute myocardial infarction. Two pathophysiologic mechanisms are discussed: either thrombosis migrating from a previously treated giant aneurism of proximal left anterior descending or a local arterial complication due to left main stenting. Recognition of these occurrences in the catheterization laboratory is important to look immediately for surgery.

2020 ◽  
Vol 13 (5) ◽  
pp. e234831
Author(s):  
Victor G Becerra-Gonzales ◽  
Marian Calfa ◽  
Rhea Sancassani

Aortic dissection is an uncommon diagnosis that typically presents with acute onset of severe pain. It rarely presents with minimal to no symptoms, which carries a higher mortality risk given the delay in diagnosis. An adequate interpretation of risk factors, clinical findings and auxiliary tests constitutes a greater value for clinicians to detect this life-threatening condition. This report describes a case of type A aortic dissection in an asymptomatic patient presenting with an abnormal electrocardiogram (ECG).


2016 ◽  
pp. 285-95
Author(s):  
Haris Munirwan ◽  
Amiliana Mardiani Soesanto ◽  
Rina Ariani ◽  
Taofan Taofan ◽  
Suko Adiarto ◽  
...  

Ascending Stanford type A aortic dissection carries a high morbidity and mortality. Proper identification of the proximal origin of the dissection and determination of concomitant aortic valve involvement significantly facilitate surgical repair which may improve survival.2Rapid imaging is necessary for the timely diagnosis of a potentially life-threatening condition. Transthoracic Echocardiography is highly accurate for the detection of acute aortic syndromes especially identify ascending aortic pathology such as type A aortic dissection.3 We report the unusual case of 52-years old male who present atypical presentation of aortic dissection with unclear view of dissection by CT Angiography aorta, and diagnosed as Localized Stanford A Aortic dissection with supported data by echocardiography modality.


2013 ◽  
Vol 2013 ◽  
pp. 1-3 ◽  
Author(s):  
Erol Kohli ◽  
Sharhabeel Jwayyed ◽  
Gary Giorgio ◽  
Mary Colleen Bhalla

Aortic dissection is a relatively rare yet often fatal condition. Early recognition and treatment are crucial for survival. While the majority of patients who present with aortic dissection are older than 50 years of age and have a history of hypertension, younger patients with connective tissue disease, bicuspid aortic valves, and a family history of aortic dissection are also at an increased risk for developing this condition. A review of the literature revealed a paucity of published cases describing the successful, emergent repair of acute type A aortic dissections in third- trimester gravid patients. We present the case of the successful diagnosis and surgical repair of a 41-year-old female who presented to the emergency department with an acute type A aortic dissection at 36 weeks of gestation.


Aorta ◽  
2021 ◽  
Vol 09 (05) ◽  
pp. 184-185
Author(s):  
Azhar Hussain ◽  
Alessia Rossi ◽  
Alexander Smith ◽  
Ana Lopez-Marco ◽  
Amina Khalil ◽  
...  

AbstractType 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.


Aorta ◽  
2018 ◽  
Vol 06 (01) ◽  
pp. 034-036
Author(s):  
Fabio Ramponi ◽  
Theone Papps ◽  
James Edwards

AbstractPatients presenting with acute onset of chest pain require prompt diagnosis and rapid establishment of a management plan. Acute aortic dissection and acute pulmonary embolism are life-threatening emergencies that can mimic each other at presentation. Correct identification of this uncommon scenario is crucial to initiate the appropriate interventions. The authors present a unique case of concomitant acute type A aortic dissection and acute saddle pulmonary embolism; the patient underwent successful aortic repair and pulmonary embolectomy.


2021 ◽  
pp. 021849232199738
Author(s):  
Juan F Parra ◽  
Eric E Vinck ◽  
Jessica N González ◽  
Hernando Santos

Acute type A thoracic aortic dissection is a life-threatening condition that requires rapid diagnosis and prompt surgical intervention. Prior cardiac surgery is recognized as a predisposing risk factor. Here, we report a rare case and successful surgical repair of a late presenting acute type A thoracic aortic dissection four years after a three-vessel coronary artery bypass grafting. Resection of the aortic valve and aneurysmal tissue was required, reconstruction was done with a composite graft, and the native coronary ostia and aorto-saphenous buttons were preserved.


2021 ◽  
Author(s):  
Xiaofeng Xu ◽  
Yunqing Cheng ◽  
Juntao Kuang ◽  
Xuejun Xie ◽  
Jinsong Huang ◽  
...  

Abstract BackgroundHeart transplantation is a major method in the treatment of end-stage heart disease. Acute type A aortic dissection is a rare and life-threatening disease requiring emergency surgery. Although surgical treatment has achieved certain progress in terms of techniques and equipment in the recent years, the surgical mortality rate is still as high as 25%. It is very rare for patients with end-stage heart disease to simultaneously contract aortic dissection. This study will explore the main points of care after end-stage heart disease combined with aortic dissection.ResultsThe cold ischemic times of the donor heart of the two patients were 340 min and 361 min, and the cardiopulmonary bypass times were 381 min and 411 min. Both were successfully operated and discharged uneventfully. ConclusionsThe combination of heart transplantation with aortic dissection surgery is complicated and is prone to multiple postoperative complications. The nursing staff is required to master the main points of care after heart transplantation and aortic dissection, observe problems in a timely manner, intervene early, and promote the patient’s recovery.


Author(s):  
Rehan Shahid ◽  
◽  
Adnan Izhar ◽  
Ali Husnain ◽  
Anum Sohail ◽  
...  

Aortic dissection is intimal tear in aorta and collection of blood in between the layers of aortic wall. The incidence of acute type A aortic dissection is between 2.1 and 16.3 per 100,000 persons [1]. Aortic dissection is an infrequent but potentially life threatening complication of pregnancy with most of the cases occurring in third trimester and post-partum period [2]. The most important predisposing factors to aortic dissection are Marfan, Ehlers-Danlos, Turner and Loeys-Dietz syndromes [3]. However, the non sporadic cases can also occur in pregnancy [4].


Author(s):  
Xuan Jiang ◽  
Enyi Shi ◽  
Ruixin Fan ◽  
Ximing Qian ◽  
Hongjia Zhang ◽  
...  

Background: Acute type A aortic dissection(ATAAD) is life-threatening and requires immediate surgery. Sudden chest pain may lead to a risk of misdiagnosis as acute coronary syndrome and may lead to subsequent antiplatelet therapy. We used the Chinese Acute Aortic Syndrome Collaboration Database (AAS) to study the effects of antiplatelet therapy (APT) on clinical outcomes. Methods: The AAS database is a retrospective multicentre database where 31 of 3092 had APT with aspirin or clopidogrel or both before surgery. Before and after propensity score matching, the incidence of complications and mortality was compared between APT and non-APT patients by using a logistic regression model. The sample remaining after PSM was 30 in the APT group and 80 in the non-APT group. Results: The sample remaining after matching was 30 in the APT group and 80 in the non-APT group. We found 10 cases with percutaneous coronary intervention in the APT group(33.3%). The APT group received more volume of packed red blood cell (RBC), 8.4±6.05 units; plasma, 401.67±727 ml, and platelet transfusion(14.07±8.92 units). The drainage volume was much more in the APT group( 5009.37±2131.44ml, P=0.004). Mortality was higher in APT group(26% vs 10%, P=0.027). The preoperative APT was independent predictor of mortality(OR 6.808, 95% CI1.554-29.828, P = 0.011). Conclusion: APT prior to ATAAD repair was associated with more transfusions and higher early mortality. The timing of surgery should be carefully considered based on the patient’s status and the surgeon’s experience.


2020 ◽  
Author(s):  
Yoshihiro Suematsu ◽  
Satoshi Nishi ◽  
Daisuke Arima ◽  
Akihiro Yoshimoto

Abstract Background: Acute aortic dissection (AAD) is a life-threatening condition which can lead to coronary, brachiocephalic or branch vessel malperfusion, as well as aortic valve insufficiency, or aortic rupture. Mortality of surgical treatment in high-risk or elderly patients with Type A AAD (TAAAD) still remains high, and treatment for such patients remains controversial. We report a successful treatment of TAAAD with a communicating false lumen in a 60-year-old man with acute hemi-cerebral malperfusion. Case presentation: The ascending aorta was wrapped with stepwise external wrapping (SEW) procedure, and subsequent thoracic endovascular aortic repair (TEVAR) was successfully performed. The patient was discharged in good physical condition without any complications. Conclusions: Hybrid therapy with SEW and TEVAR with TAAAD associated with major cerebral malperfusion should be considered, especially in patients for whom open surgery is extremely risky.


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