Clinical review for general practice

ISSN (Print) 2713-2552
ISSN (Online) 2782-5671
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FULLSCREEN > Archive > 2024 > Vol 5, №10 (2024) > Infarction-like electrocardiogram during aortic dissection

Infarction-like electrocardiogram during aortic dissection

N.Yu. Tsibulskaya , E.I. Harkov , E.I. Ryabkov , U.A. Kononovich , A.D. Mashintseva

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Abstract

A clinical example demonstrates the difficulties of differential diagnosis of infarct-like ECG during aortic dissection. The difficulty of diagnosis was the absence of pain, impaired consciousness of the patient, the presence of anisocoria, ECG changes simulating acute myocardial infarction with ST segment elevation, and the presence of obstructive changes in the coronary arteries according to the results of coronary angiography. The diagnosis was initially confirmed by aortography, then by multislice computed tomography of the aorta and echocardiography. Possible clinical diagnostic signs of aortic dissection are given.
Keywords: aortic dissection, acute myocardial infarction, differential diagnosis, ECG, ST segment elevation.

About the Author

N.Yu. Tsibulskaya 1 , E.I. Harkov 1 , E.I. Ryabkov 2 , U.A. Kononovich 3 , A.D. Mashintseva 3

1 Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia; Emergency Hospital named after. N.S. Karpovich, Krasnoyarsk, Russia

2 Emergency Hospital named after. N.S. Karpovich, Krasnoyarsk, Russia

3 Professor V.F. Voino-Yasenetsky Krasnoyarsk State Medical University, Krasnoyarsk, Russia

References

1. Hagan PG, Nienaber CA, Isselbacher EM et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA. 2000;283(7):897-903. DOI: 10.1001/jama.283.7.897
2. Клинические рекомендации. Рекомендации по диагностике и лечению заболеваний аорты (2017). Кардиология и сердечно-сосудистая хирургия. 2018;11(1):7-67. Clinical Guidelines. Guidelines for the Diagnosis and Treatment of Aortic Diseases (2017). Russian Journal of Cardiology and Cardiovascular Surgery. 2018;11(1):7-67 (in Russian).
3. Evangelista А, Isselbacher ЕМ, Bossone Е et al. Insights From the International Registry of Acute Aortic Dissection. A 20-Year Experience of Collaborative Clinical Research. Circulation. 2018;137(7): 1846-1860. DOI: CIRCULATIONAHA.117.031 264
4. Bonnefoy E, Godon P, Kirkorian G et al. Significance of serum troponin I elevation in patients with acute aortic dissection of the ascending aorta. Acta Cardiol. 2005;60(2):165-70. DOI: 10.2143/AC. 60.2.2005027

For citation:Tsibulskaya N.Yu., Harkov E.I., E.I. Ryabkov E.I., Kononovich U.A., Mashintseva A.D. Infarction-like ecg during aortic dissection. Clinical review for general practice. 2024; 5 (10): 78–82 (In Russ.). DOI: 10.47407/kr2024.5.10.00499


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