Document Detail

A case of aortic dissection with transient ST-segment elevation due to functional left main coronary artery obstruction.
MedLine Citation:
PMID:  10716527     Owner:  NLM     Status:  MEDLINE    
A 48-year-old man with a history of hypertension and diabetes mellitus was hospitalized with sudden onset of severe chest pain. He was in cardiogenic shock with a systolic pressure of 60 mm Hg. His electrocardiogram (ECG) showed ST-segment elevation in the precordial leads suggestive of acute anteroseptal myocardial infarction. The ST-segment returned to baseline after the systolic blood pressure rose to 100 mm Hg with the administration of sympathomimetic agents. Aortography and transesophageal echocardiography demonstrated type A aortic dissection and aortic regurgitation. Aortography and short-axis transesophageal echocardiography showed during diastole almost complete collapse of the true lumen of the ascending aorta caused by the intimal flap. The patient underwent surgical repair of the aortic dissection and implantation of Palmaz stents in the carotid arteries. Decreased blood pressure and the presence of aortic regurgitation accelerated the collapse of the true lumen during diastole in the ascending aorta, resulting in functional obstruction of the left main coronary artery, which may have been related to ST-segment changes in this case.
K Ashida; K Arakawa; T Yamagishi; T Tahara; M Ayaori; K Miyazaki; T Shibuya; N Hatori; H Yoshizu; T Tanaka; F Ohsuzu
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Japanese circulation journal     Volume:  64     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  2000 Feb 
Date Detail:
Created Date:  2000-04-04     Completed Date:  2000-04-04     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  AUSTRALIA    
Other Details:
Languages:  eng     Pagination:  130-4     Citation Subset:  IM    
The First Department of Internal Medicine, National Defense Medical College, Tokorozawa, Japan.
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MeSH Terms
Aneurysm, Dissecting / etiology*,  physiopathology*,  surgery
Aortic Valve Insufficiency / etiology,  physiopathology
Blood Pressure
Coronary Disease / complications*,  physiopathology*,  surgery
Middle Aged
Myocardial Ischemia / etiology,  physiopathology

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