title: Obstruction of the right coronary artery ostium due to acute aortic dissection.
abstract: Acute aortic dissection presents with a wide range of manifestations and it is frequently confused with acute coronary syndrome, leading to delayed diagnosis and inappropriate treatment. A high clinical index of suspicion is necessary. Longstanding arterial hypertension, elevated D-dimer levels and new onset atypical chest pain can help the clinician to perform a difficult differential diagnosis. We present a case of acute aortic dissection in a 68-year-old Italian woman with longstanding arterial hypertension, unknown ascending aortic aneurysm, normal D-dimer levels, new onset atypical chest pain and electrocardiographic images mimicking acute coronary syndrome. Also this case focuses attention on the importance of a correct evaluation of new onset chest pain.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Patanè
authors.forename: Filippo
authors.initials: F
authors.lastname: Marte
authors.forename: Salvatore
authors.initials: S
authors.lastname: Lentini
authors.forename: Francesco
authors.initials: F
authors.lastname: Monaco
authors.forename: Sossio
authors.initials: S
authors.lastname: Perrotta
authors.forename: Gianluca
authors.initials: G
authors.lastname: Di Bella
authors.forename: Francesco
authors.initials: F
authors.lastname: Patanè
authors.forename: Roberto
authors.initials: R
authors.lastname: Gaeta
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis*; D017545:Aortic Aneurysm, Thoracic / Q000175:diagnosis*; D002637:Chest Pain / Q000175:diagnosis*; D023921:Coronary Stenosis / Q000175:diagnosis*; D003937:Diagnosis, Differential; D004562:Electrocardiography; D005260:Female; D006801:Humans