Acute Aortic Dissection Mimicking STEMI in the Catheterization

Copyright © 2012 Alessio Arrivi et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. 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. 1. Case Report A 77-year-old woman presented complaining from the sudden onset of acute retrosternal pain radiating to the left arm. Three months earlier, the patient was referred to our laboratory for a giant, calcified, aneurism of proximal LAD and coronary subocclusion immediately proximal to the sac (Figure 1(A)) and percutaneous coronary intervention (PCI) was performed using a 3.5 × 14mm bare metal stent (BMS