Key result
Intravascular ultrasound successfully diagnosed an acute type A aortic dissection presenting as a STEMI, enabling life-saving emergency percutaneous coronary intervention as a bridge to surgery.
Why the study?
Coronary occlusion during type A aortic dissection is a serious complication associated with high mortality if not identified and treated promptly.
Case Report (n=1)
No
Intravascular ultrasound can promptly diagnose acute type A aortic dissection in patients presenting with STEMI, enabling initial reperfusion with PCI as a life-saving bridge to definitive surgical repair.
May facilitate IVUS diagnosis of type A dissection during STEMI PCI; leaves open routine use pending prospective data.
BACKGROUND: Coronary occlusion during type A aortic dissection is a serious complication, associated with high mortality if not identified and treated promptly. CASE SUMMARY: We present a case of acute type A aortic dissection, diagnosed with intravascular ultrasound during emergency percutaneous coronary intervention (PCI) for ST-elevation myocardial infarction. Emergency PCI was successfully performed as a bridge to definitive central aortic repair surgery. DISCUSSION: This case highlights the integration of multiple diagnostic cardiac imaging modalities in the time-critical evaluation and management of aortic dissection as a cause for ST-elevation myocardial infarction. This case also demonstrates the coordinated multidisciplinary care essential to the initial and long-term management of this life-threatening condition. TAKE-HOME MESSAGES: This case highlights the ability to promptly diagnose acute type A aortic dissection using intravascular ultrasound in patients presenting with acute coronary syndrome. Initial reperfusion with PCI can provide a life-saving bridge to definitive surgical repair.
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Hopkins et al. (2025) conducted a case report in Type A Aortic Dissection presenting as Acute Myocardial Infarction (n=1). Intravascular ultrasound and percutaneous coronary intervention was evaluated on Diagnosis and stabilization. Intravascular ultrasound successfully diagnosed an acute type A aortic dissection presenting as a STEMI, enabling life-saving emergency percutaneous coronary intervention as a bridge to surgery.
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