Key result
Point-of-care ultrasound using a suprasternal notch view rapidly identified an ascending aortic dissection in a patient presenting with an inferior STEMI, altering the course of treatment.
Case Report (n=1)
No
Point-of-care ultrasound using the suprasternal notch view can rapidly identify ascending aortic dissection in patients presenting with inferior STEMI, preventing catastrophic outcomes from inappropriate anticoagulation.
May warrant POCUS for dissection in inferior STEMI to avoid anticoagulation harm; hypothesis-generating and should not yet change practice.
CASE PRESENTATIONAn 88-year-old female presented to the emergency department (ED) after a syncopal event.Upon arrival, the patient was awake and complaining of chest pain.An electrocardiogram was performed showing an inferior ST-elevation myocardial infarction (STEMI).Patient's vital signs were heart rate of 86 beats/minute, blood pressure of 83/50 mmHg, temperature of 98.8 degrees Fahrenheit, respiratory rate of 18/minute, and oxygen saturation 96% while breathing room air.Dorsalis pedis pulses were difficult to appreciate bilaterally and the patient was agitated and diaphoretic.A focused cardiac ultrasound (FOCUS), including a suprasternal notch view (SSNV), was performed (Image 1).
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Dwyer et al. (2017) conducted a case report in Ascending aortic dissection (n=1). Point-of-care ultrasound (suprasternal notch view) was evaluated. Point-of-care ultrasound using a suprasternal notch view rapidly identified an ascending aortic dissection in a patient presenting with an inferior STEMI, altering the course of treatment.
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