Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

Abstract

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

Acute Stanford type A aortic dissection with the “giant R wave” electrocardiogram pattern: a case report

“…The "giant Rwave" ECG pattern can indicate not only coronary artery occlusion or spasms but also AD involving the coronary arteries. TTE or CTA are important examinations, especially in patients with high D-dimer levels, as they can help to reduce misdiagnosis [15] . TAAD with coronary artery involvement is a dangerous condition with high mortality, In such case, aggressive with reperfusion via percutaneous intervention to obtain stable vital signs, in order to race against time for subsequent surgery of TAAD maybe the rst-line choice.…”