[Severe left main stem stenosis in preoperative cineangiography - acute aortic dissection as intraoperative final diagnosis].
Acute aortic dissection occurs in 0.5-2.95 cases per 100,000 citizens-year. Although the modern diagnostic tools help in  more accurate diagnosis, the missleading findings still occure. We present a case of a 72-year-old man who was admitted to  cardiology ward due to persistent chest pain. Initial diagnosis of acute coronary syndrome was confirmed by electrocardiography  (ST segment depression in V(1)-V(5) leads), transthoracic echocardiography (anterior wall dyskinesis) and laboratory tests  (Tn-I: 6.92 μ/L, CK-MB: 226.24 ng/mL). Due to aortic aneurysm history, computer tomography (CT) was performed. Neither  CT nor transthoracic echocardiography were negative for aortic dissection. Intraoperatively aortic dissection limited to Valsalva  sinuses was found. Left main orifice was blindly closed followed by Bentall procedure and coronary artery revascularisation.
Klinika Kardiochirurgii, Szpital Kliniczny Przemienienia Pańskiego, 61–848 Poznań. tomasz.urbanowicz@skpp.edu.pl
Tomasz
T
Urbanowicz
Maciej
M
Mączyński
Ewa
E
Straburzyńska-Migaj
Marek
M
Jemielity
D054058:Acute Coronary Syndrome / Q000175:diagnosis; D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis* / Q000601:surgery*; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000601:surgery*; D002932:Cineangiography; D003937:Diagnosis, Differential; D004452:Echocardiography; D004562:Electrocardiography; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D014057:Tomography, X-Ray Computed