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KMID : 0882420130850050516
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Korean Journal of Medicine
2013 Volume.85 No. 5 p.516 ~ p.520
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Atypical Coronary Occlusion in a Patient with ST-Elevation Myocardial Infarction Caused by a Masked Aortic Dissection
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Park Byoung-Won
Seo Dae-Chul
Moon In-Ki
Chung Jin-Wook
Bang Duk-Won
Hyon Min-Su
Jang Won-Ho
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Abstract
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ST-elevation myocardial infarction (STEMI) caused by an acute aortic dissection is relatively rare. A diagnosis of dissection can be missed and the situation can become complicated. We report a patient who presented with acute aortic dissection responsible for STEMI related to a dissecting flap into the right coronary artery. This case emphasizes the need for careful assessment of the aorta in cases of atypical coronary occlusion in patients with STEMI without evidence of atherosclerosis in non-culprit coronary segments. The patient was discharged 7 days after primary percutaneous intervention for STEMI. However, she revisited the emergency department for recurrent chest pain and aortic dissection and was diagnosed and managed successfully with surgery.
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KEYWORD
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Dissection, Aorta, Myocardial infarction, Myocardial revascularization
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