Intractable supraventricular tachycardia as first presentation of thoracic aortic dissection Case report

A patient presented with palpitations at the emergency department 3 days after a percutaneous coronary intervention complicated by dissection of the left anterior descending and circumflex coronary arteries. Physical examination revealed a high pulse rate and low blood pressure and the electrocardiogram demonstrated atrioventricular nodal re-entry tachycardia. This arrhythmia was eventually terminated by electrical cardioversion. Echocardiography demonstrated moderate aortic regurgitation and subsequent computed tomography showed a large Stanford type A aortic dissection. The patient was successfully operated and discharged 10 days after surgery. (C) 2008 Elsevier Ireland Ltd. All rights reserved