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Stanford type A acute dissection developing acute myocardial infarction

  • Norifumi Ohtani
  • Keiko Kiyokawa
  • Hidenori Asada
  • Toshiaki Kawakami
Case Report

Abstract

A 75-year-old female, exhibiting epigastric pain and vomiting, underwent treatment for acute gastritis. She also experienced incontinence of urine and chest pain. A diagnosis of acute myocardial infarction was made upon examination of electrocardiographic findings and the patient was transferred to our hospital. Diffuse infarction of the left ventricle and acute aortic dissection (Stanford type A) were diagnosed by electrocardiographic and echo-cardiography. An emergency operation was performed. After induction of anesthesia, elevation of pulmonary artery pressure and fall of pulse pressure were observed, indicating acute cardiac tamponade. Transesophageal ultrasonography disclosed the entry of dissection in the descending aorta. Dissection of the aorta extended proximally up to the annulus of the aortic valve and the right and left coronary arteries were compressed by its aneurysm. As aortic insufficiency was mild, only reconstruction of the ascending aorta was carried out The patient was discharged in fair condition one month after operation under use of postoperative long-term administration of catecholamines.

Index words

acute aortic dissection acute myocardial infarction DeBakey type III retrograde dissociation diffuse infarction of the left ventricle 

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Copyright information

© The Japanese Society of Thoracic and Cadiovascular Surgery 2000

Authors and Affiliations

  • Norifumi Ohtani
    • 1
  • Keiko Kiyokawa
    • 1
  • Hidenori Asada
    • 1
  • Toshiaki Kawakami
    • 1
  1. 1.Department of Cardiovascular SurgeryShin-Nittetsu Muroran General HospitalHokkaidoJapan

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