• Mehmet Eren, Tolga Sinan Güvenç, Hatice Betül Erer, Rengin Çetin, Hakan Hasdemir, Erkan İlhan, and Ceyhan Türkkan.
• Department of Cardiology, Training and Research Hospital, Siyami Ersek Thoracic and Cardiovascular Surgery Center, Istanbul, Turkey.
• J Emerg Med. 2013 Jan 1;44(1):e5-8.

BackgroundAortic dissection is an important cause of acute chest pain that should be rapidly diagnosed, as mortality increases with each hour this condition is left untreated. The diagnosis can be challenging, especially if concomitant myocardial infarction is present. Echocardiography is an important tool for the differential diagnosis.ObjectivesTo stress the importance of recognizing aortic regurgitation for the differentiation of myocardial infarction and aortic dissection.Case ReportAn 80-year-old woman was admitted to our hospital with chest pain that was diagnosed as inferior and lateral wall myocardial infarction based on electrocardiographic findings. The diagnosis was reevaluated when aortic regurgitation was detected on echocardiography. Closer inspection of the ascending aorta revealed a dissection flap as the cause of aortic regurgitation.ConclusionDetection of aortic regurgitation in a patient with myocardial infarction and normal valves should prompt the search for a possible aortic dissection, whether or not the dissection flap can be visualized.Copyright © 2013 Elsevier Inc. All rights reserved.

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