Key result
Recognizing angiographic clues during suspected STEMI reveals type A aortic dissection and prevents unnecessary PCI.
Case Report (n=1)
Recognizing specific angiographic clues during emergency catheterization for suspected STEMI can prevent inappropriate PCI and expedite life-saving surgery for type A aortic dissection.
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Alerts clinicians to cath-lab clues for type A dissection in STEMI; leaves open prospective validation of diagnostic criteria.
IMAGE(S): Emergency coronary angiography and computed tomography angiography showing catheterization laboratory (Cath-Lab) clues to type A aortic dissection presenting as acute myocardial infarction. CASE SUMMARY: A 67-year-old man underwent emergency angiography for anterior ST-segment elevation. Difficult coronary engagement, thin strip-like left coronary narrowing, and marked catheter swing prompted reassessment. Computed tomography angiography confirmed type A aortic dissection involving the left main ostium, and unnecessary percutaneous coronary intervention was avoided. Five recurring angiographic warning clues are summarized. TAKE-HOME MESSAGES: These 5 practical Cath-Lab clues would help you away from emergency type A aortic dissection trap. Timely recognition of Cath-Lab clues and pause; activate the aortic surgical team.
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Wang et al. (2026) conducted a case report in Type A aortic dissection presenting as acute myocardial infarction (n=1). Recognition of Cath-Lab clues (difficult coronary engagement, thin strip-like left coronary narrowing, marked catheter swing) was evaluated. Recognition of specific angiographic clues during emergency angiography for suspected STEMI successfully identified type A aortic dissection and prevented unnecessary percutaneous coronary intervention.
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