Acute aortic regurgitation with myocardial infarction: an important clue for aortic dissection.
BACKGROUND
Aortic dissection is an important cause of acute chest pain that should be rapidly diagnosed, as mortality increases with each hour this condition is left untreated. The diagnosis can be challenging, especially if concomitant myocardial infarction is present. Echocardiography is an important tool for the differential diagnosis.


OBJECTIVE
To stress the importance of recognizing aortic regurgitation for the differentiation of myocardial infarction and aortic dissection.


METHODS
An 80-year-old woman was admitted to our hospital with chest pain that was diagnosed as inferior and lateral wall myocardial infarction based on electrocardiographic findings. The diagnosis was reevaluated when aortic regurgitation was detected on echocardiography. Closer inspection of the ascending aorta revealed a dissection flap as the cause of aortic regurgitation.


CONCLUSIONS
Detection of aortic regurgitation in a patient with myocardial infarction and normal valves should prompt the search for a possible aortic dissection, whether or not the dissection flap can be visualized.
Department of Cardiology, Training and Research Hospital, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
Tolga Sinan
TS
Güvenç
Hatice Betül
HB
Erer
Rengin
R
Çetin
Hakan
H
Hasdemir
Erkan
E
İlhan
Ceyhan
C
Türkkan
Mehmet
M
Eren
D000208:Acute Disease; D000369:Aged, 80 and over; D000784:Aortic Dissection / Q000150:complications / Q000175:diagnosis*; D001014:Aortic Aneurysm / Q000150:complications / Q000175:diagnosis*; D001022:Aortic Valve Insufficiency / Q000175:diagnosis* / Q000209:etiology; D003937:Diagnosis, Differential; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D056989:Inferior Wall Myocardial Infarction / Q000175:diagnosis; D009203:Myocardial Infarction / Q000175:diagnosis*