Coronary spasm due to type A aortic dissection complicated by hemopericardium: a case report of another possible cause of coronary malperfusion.
Coronary malperfusion complicating Type A aortic dissection is relatively rare. The diagnosis of Type A aortic dissection as the cause of coronary ischemia is a challenge. The mechanism of coronary malperfusion has been proposed. We report a 45-year-old man presenting with acute inferior wall ST segment elevation myocardial infarction who was finally diagnosed to have Type A aortic dissection complicated by hemopericardium and cardiac tamponade. Coronary spasm is the most likely cause of transient myocardial ischemia in this patient and should be considered as another possible cause of coronary malperfusion in patients with Type A aortic dissection.
Chamnarnphol
Noppadol
N
Division of Cardiovascular Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hadyai, Songkhla, Thailand. cnoppado@hotmail.com
Cheewatanakornkul
Sirichai
S
Wisaratapong
Treechada
T
D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D015906:Angioplasty, Balloon, Coronary / Q000379:methods; D017545:Aortic Aneurysm, Thoracic / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D019917:Blood Vessel Prosthesis Implantation / Q000379:methods; D006328:Cardiac Catheterization / Q000379:methods; D017023:Coronary Angiography / Q000379:methods; D003329:Coronary Vasospasm / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology; D017548:Echocardiography, Transesophageal; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D010490:Pericardial Effusion / Q000209:etiology / Q000601:surgery*; D011183:Postoperative Complications / Q000000981:diagnostic imaging / Q000601:surgery; D018570:Risk Assessment; D016896:Treatment Outcome