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  • Title: An uncommon presentation of acute type A aortic dissection: left main coronary artery obstruction.
    Author: Courand PY, Dauphin R, Roussel E, Besnard C, Lantelme P.
    Journal: J Cardiovasc Med (Hagerstown); 2012 Jan; 13(1):53-5. PubMed ID: 21670701.
    Abstract:
    Acute aortic dissection presents with a wide range of manifestations. Sometimes an acute coronary syndrome is diagnosed instead of aortic dissection leading to inappropriate treatment. We describe a case of acute aortic dissection with the uncommon involvement of the left main coronary artery. A 64-year-old man was referred to our hospital for primary coronary intervention because ECG demonstrated ST elevation in the aVR lead with diffuse ST-segment depression. Coronary angiography was performed to treat the culprit lesion but the left main coronary artery could not be catheterized. Aortography and transesophageal echocardiography confirmed Stanford type A aortic dissection. The patient died of cardiac arrest in spite of cardiopulmonary resuscitation. This case also illustrates how Stanford type A aortic dissection can present with left main coronary artery obstruction.
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