title: Acute type A aortic dissection involving right coronary artery orifice in a case presenting with anterior ST elevation: a rare case report.
abstract: Functional coronary artery occlusion due to type A aortic dissection has rarely been reported in the literature. We report a case of aortic dissection presenting with anterior ST elevation. Coronary angiography revealed normal findings and chest computed tomography-confirmed type A aortic dissection. Emergent surgery was performed and dissection involving the right coronary artery orifice was found. An electrocardiogram after the operation revealed resolution of anterior ST elevation. The mechanism of initial anterior but not inferior ST elevation should be related to functional obstruction of the left main coronary artery by intimal flap and reciprocal ST-T change over inferior leads.
authors.affiliation: Division of Cardiology, Department of Internal Medicine, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan, ROC.
authors.forename: Po-Chao
authors.initials: PC
authors.lastname: Hsu
authors.forename: Ho-Ming
authors.initials: HM
authors.lastname: Su
authors.forename: Tsung-Hsien
authors.initials: TH
authors.lastname: Lin
authors.forename: Jiann-Wei
authors.initials: JW
authors.lastname: Huang
authors.forename: Wen-Ter
authors.initials: WT
authors.lastname: Lai
authors.forename: Sheng-Hsiung
authors.initials: SH
authors.lastname: Sheu
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D001011:Aorta / Q000473:pathology; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D001145:Arrhythmias, Cardiac; D013504:Cardiovascular Surgical Procedures; D017023:Coronary Angiography; D003937:Diagnosis, Differential; D004562:Electrocardiography; D006801:Humans; D008297:Male; D014057:Tomography, X-Ray Computed