Aortic Dissection with Subsequent Hemorrhagic Tamponade Diagnosed with Point-of-care Ultrasound in a Patient Presenting with STEMI

A 58-year-old male with no past medical history presented to the emergency department with sudden onset left lower extremity weakness and central chest pain with radiation to his back. Electrocardiogram revealed an acute inferior and posterior ST-segment elevation myocardial infarction (STEMI). Poin...

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Bibliographic Details
Published in:Clinical practice and cases in emergency medicine 2019-05, Vol.3 (2), p.103-106
Main Authors: Abrams, Eric, Allen, Angela, Lahham, Shadi
Format: Article
Language:English
Subjects:
Aneurysms
Aortic dissection
Case Report
Electrocardiography
Ultrasonic imaging
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Summary:A 58-year-old male with no past medical history presented to the emergency department with sudden onset left lower extremity weakness and central chest pain with radiation to his back. Electrocardiogram revealed an acute inferior and posterior ST-segment elevation myocardial infarction (STEMI). Point-of-care ultrasound (POCUS) demonstrated right ventricular akinesis consistent with infarction, and an intimal defect consistent with an aortic dissection. We determined that cardiothoracic surgery was indicated rather than left-heart catheterization and anticoagulation. Using POCUS we were able to immediately diagnose a dissection of the aortic arch and considerably alter treatment in a patient presenting with STEMI.
ISSN:2474-252X
2474-252X
DOI:10.5811/cpcem.2019.1.40869