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

• 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
• ISSN: 0736-4679; 2352-5029
• DOI: 10.1016/j.jemermed.2011.05.100

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.