Key result
Type A aortic dissection complicating STEMI angiography is managed conservatively through shared decision-making.
Why the study?
Coronary angiography is widely utilized to evaluate coronary blood flow and detect coronary artery disease, but rare and severe complications such as aortic dissection can occur.
Case Report (n=1)
Highlights potential for iatrogenic type A dissection during STEMI angiography; leaves open conservative management in select elderly cases.
Key Clinical Message: Aortic dissection is one of the rare complication of coronary angiography. The main treatment underlies surgical intervention however; management should be done with patient's decision. Abstract: Coronary angiography (CA) is a widely utilized diagnostic procedure used to evaluate blood flow through the coronary arteries and detect coronary artery disease (CAD). Despite its widespread use, it has complications including non-life-threatening, while there are some rare complications that can occur. We present a case of an elderly woman who presented with ST elevation myocardial infarction (STEMI) and underwent CA without evidence of CAD. However, the patient later developed type A aortic dissection (AD) as a complication of the procedure. Surgery is considered emergent treatment for type A-AD, but the patient was asymptomatic without any complaint, shared decision making was conducted and the patient decided to pursue conservative treatment without surgical intervention. Therefore, managing AD should be tailored to each patient individually through shared-decision making.
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Gonzalez et al. (2023) conducted a case report in ST elevation myocardial infarction (STEMI) (n=1). Coronary angiography was evaluated on Type A aortic dissection. Diagnostic coronary angiography in an elderly woman presenting with STEMI was complicated by a type A aortic dissection, which was managed conservatively through shared decision-making.
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