A patient with chest pain and a pulsating left main coronary artery
Acute proximal AD is complicated by retrograde dissection into either or both coronary ostia in 5.7–15% of cases [1, 2]; misdiagnosis with ACS may have a fatal outcome . Dynamic LMCA lumen compromise during diastole is highlighted herein as a subtle and rare angiographic finding that should alert the interventional cardiologist to possible proximal AD extending into the LMCA.
Conflict of interest
A.Y. Andreou, A. Karyou and A. Argyrou declare that they have no competing interests.
Video 1 Non-selective left coronary artery angiography showing dynamic left main coronary artery lumen compromise during diastole
Video 2 Echocardiographic image. Parasternal long-axis view showing a dilated aortic root harbouring a dissection flap
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