Acute Aortic Regurgitation with Myocardial Infarction: An Important Clue for Aortic Dissection

Abstract 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...

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Bibliographic Details
Published in:The Journal of emergency medicine 2013, Vol.44 (1), p.e5-e8
Main Authors: Güvenç, Tolga Sinan, MD, Erer, Hatice Betül, MD, Çetin, Rengin, MD, Hasdemir, Hakan, MD, İlhan, Erkan, MD, Türkkan, Ceyhan, MD, Eren, Mehmet, MD, FESC
Format: Article
Language:English
Subjects:
Acute Disease
Aged, 80 and over
Aneurysm, Dissecting - complications
Aneurysm, Dissecting - diagnosis
Aortic Aneurysm - complications
Aortic Aneurysm - diagnosis
aortic dissection
aortic regurgitation
Aortic Valve Insufficiency - diagnosis
Aortic Valve Insufficiency - etiology
Diagnosis, Differential
echocardiography
Echocardiography, Transesophageal
Emergency
Female
Humans
Inferior Wall Myocardial Infarction - diagnosis
myocardial infarction
Myocardial Infarction - diagnosis
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Summary:Abstract 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. Objectives To stress the importance of recognizing aortic regurgitation for the differentiation of myocardial infarction and aortic dissection. Case Report 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. Conclusion 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.
ISSN:0736-4679
2352-5029
DOI:10.1016/j.jemermed.2011.05.100