Author: Christian Loewe, Vienna, Austria
Body Region: Cardiovascular
1. Patient Presentation
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A 71-year-old man with a history of mitral valve repair was admitted because of acute chest pain.
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A typical ST elevation and high troponin-T levels led to a diagnosis of ST-elevation myocardial infarction (STEMI), so the patient underwent emergency coronary revascularization with a left radial artery approach due to anatomical circumstances.
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During the procedure, cannulation of the right coronary artery proved technically difficult due to stenosis (Fig. 1a). A iatrogenic aortic dissection was nonetheless recognized and an acute aortic syndrome was diagnosed (Fig. 1b) and successfully treated.
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Following treatment of the acute coronary syndrome, the patient still reported severe chest pain, so CT angiography was performed (Fig. 2).