Case Sharing: A Case of Aortic Dissection that was Complicated by Myocardial Infarction of the Left Main Coronary Artery: Percutaneous Coronary Angioplasty and PCPS Followed by Ascending Arch Replacement
Introduction
- Standford type A acute aortic dissection is not an uncommon complication of coronary artery malperfusion, with a reported frequency of 5.7% to 11.3%1).
- When coronary malperfusion is complicated by myocardial infarction, hospital mortality is reported to be as high as 20%-33%, and the prognosis is poor due to low cardiac output syndrome and other factors caused by severe myocardial damage 2).
- There is no established examination procedure or treatment plan.
Case example
Male in his 70s
Chief complaint
Chest pain
Current medical history
The patient was brought to our hospital as an emergency because of sudden anterior chest pain while riding a bicycle.
Previous medical history
Angina pectoris (previous PCI)
Y-graft replacement for abdominal aortic aneurysm
Coronary risk factors
Smoking history, dyslipidemia, hypertension
Patient findings on admission
Pain and restlessness
Heart sounds: No obvious murmur
Lung sounds: no rales, no left-right difference
No leg edema
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