CTICasesAortic dissection
Imaging findings
Non-contrast and contrast-enhanced chest CT in a patient presenting with acute chest pain and ST-segment elevation show a Stanford Type A aortic dissection extending to the aortic root. The dissection flap dynamically obstructs the origin of the left coronary artery, resulting in hypoperfusion of the anterior wall and subendocardium of the left ventricle.
Key takeaways
Acute Type A aortic dissection can present as an acute myocardial infarction if the dissection flap extends into the coronary sinuses or dynamically obstructs the coronary artery ostia. Coronary hypoperfusion is a surgical emergency that requires immediate aortic replacement and coronary stabilization.
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