Cai Jingjing, Cao Yu, Yuan Hong, Yang Kan, Zhu Yuan-Shan
Department of Cardiology of the Third Xiangya Hospital, Central South University, Changsha, 410013, China.
J Cardiovasc Dis Res. 2012 Apr;3(2):138-42. doi: 10.4103/0975-3583.95370.
Aortic dissection (AD) is a life-threatening condition and may present with symptoms which mimic myocardial infarction, leading to misdiagnosis and inappropriate use of anticoagulant and thrombolytic therapy. A 40-year-old woman with no prior history presented in our emergency department with sudden chest pain. Electrocardiography (ECG) showed a ST-segment elevation in leads II, III and avF, suggesting an acute inferior myocardial infarction. The patient was given anticoagulation and antiplatelet treatment. Coronary angiography, transthoracic echocardiography and computed tomography were performed. The patient was diagnosed with DeBakey I aortic dissection extending from ascending aorta to iliac artery, and associated with bicuspid aortic valve.Surgical treatments with a replacement of the ascending aorta, aortic valve replacement and coronary artery bypass grafting were successfully performed. Early imaging examination, if possible, might assist the diagnosis and guide the management of this disease. The condition of myocardial infarction secondary to aortic dissection is discussed.
主动脉夹层(AD)是一种危及生命的疾病,其症状可能类似心肌梗死,从而导致误诊以及抗凝和溶栓治疗的不当使用。一名无既往病史的40岁女性因突发胸痛就诊于我院急诊科。心电图(ECG)显示II、III和avF导联ST段抬高,提示急性下壁心肌梗死。该患者接受了抗凝和抗血小板治疗。随后进行了冠状动脉造影、经胸超声心动图和计算机断层扫描。患者被诊断为DeBakey I型主动脉夹层,累及升主动脉至髂动脉,并伴有二叶式主动脉瓣。成功实施了升主动脉置换、主动脉瓣置换和冠状动脉旁路移植术等外科治疗。早期影像学检查若可行,可能有助于本病的诊断并指导治疗。本文还讨论了主动脉夹层继发心肌梗死的情况。