Methods
A 51-year-old male presented with sudden onset of chest pain that started two hours prior to admission. He described the pain as sharp, tearing and radiating to his back. His past medical history was remarkable for ascending aortic aneurysm diagnosed ten years ago. There was family history of coronary artery disease. He declined any drug abuse, herbal medications or other over-the-counter medicines. His blood pressure was 140/80 mm Hg; equal in both arms, and pulse rate was 90 per minute. Physical examination was unremarkable with regular heart sounds without murmurs, rubs or gallops. The electrocardiogram (ECG) revealed ST elevation in leads V1-V3 and reciprocal ST depression in leads II, III, aVF. On transthoracic echocardiogram, the ascending aorta was 4.8 cm at sinus Valsalva level and neither dissection flap nor aortic regurgitation was detected. Coronary angiography was performed thereafter with prediagnosis of acute anterior wall MI based on electrocardiographic findings.
Methods
A 51-year-old male presented with sudden onset of chest pain that started two hours prior to admission. He described the pain as sharp, tearing and radiating to his back. His past medical history was remarkable for ascending aortic aneurysm diagnosed ten years ago. There was family history of coronary artery disease. He declined any drug abuse, herbal medications or other over-the-counter medicines. His blood pressure was 140/80 mm Hg; equal in both arms, and pulse rate was 90 per minute. Physical examination was unremarkable with regular heart sounds without murmurs, rubs or gallops. The electrocardiogram (ECG) revealed ST elevation in leads V1-V3 and reciprocal ST depression in leads II, III, aVF. On transthoracic echocardiogram, the ascending aorta was 4.8 cm at sinus Valsalva level and neither dissection flap nor aortic regurgitation was detected. Coronary angiography was performed thereafter with prediagnosis of acute anterior wall MI based on electrocardiographic findings.
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