Hsu Po-Chao, Su Ho-Ming, Lin Tsung-Hsien, Huang Jiann-Wei, Lai Wen-Ter, Sheu Sheng-Hsiung
Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
Cardiology. 2011;119(1):11-4. doi: 10.1159/000329516. Epub 2011 Jul 14.
Functional coronary artery occlusion due to type A aortic dissection has rarely been reported in the literature. We report a case of aortic dissection presenting with anterior ST elevation. Coronary angiography revealed normal findings and chest computed tomography-confirmed type A aortic dissection. Emergent surgery was performed and dissection involving the right coronary artery orifice was found. An electrocardiogram after the operation revealed resolution of anterior ST elevation. The mechanism of initial anterior but not inferior ST elevation should be related to functional obstruction of the left main coronary artery by intimal flap and reciprocal ST-T change over inferior leads.
