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Ann Acad Med Singap · Oct 2007
Case ReportsPeripartum acute anterior ST segment elevation myocardial infarction: an uncommon presentation of acute aortic dissection.
- Abdul Razakjr Omar, Wei-Ping Goh, and Yean-Teng Lim.
- Cardiac Department, National University Hospital, Singapore. abdul_razakjr_bin_omar@nuh.com.sg
- Ann Acad Med Singap. 2007 Oct 1; 36 (10): 854-6.
IntroductionAtherosclerotic coronary artery thrombosis is the most common cause of acute myocardial infarction.Clinical PictureA 30-year-old lady presented with acute peripartum massive anterior ST segment myocardial infarction and cardiogenic shock. This was due to acute Stanford type A aortic dissection with the intimal flap occluding the left coronary ostium. The initial diagnosis was not apparent. Echocardiography confirmed the diagnosis.Treatment And OutcomeShe underwent emergency surgical repair (Bentall procedure). Pathology confirmed underlying idiopathic cystic medial degeneration.ConclusionA high index of clinical suspicion is required in acute myocardial infarction presenting without traditional cardiovascular risk factors.
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