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http://dx.doi.org/10.14408/KJEMS.2020.24.3.141

Case reports : Proximal aortic dissection with STEMI-equivalent ECG findings  

Kim, Ji-Won (Department of Emergency Medicine, College of Medicine, Dankook University)
Kang, Min Seong (Department of Preventive Medicine, College of Medicine, Hanyang University)
Publication Information
The Korean Journal of Emergency Medical Services / v.24, no.3, 2020 , pp. 141-145 More about this Journal
Abstract
The most common symptom of aortic dissection is chest pain, which is similar to acute coronary artery syndrome, making it difficult to diagnose with clinical pattern, requiring various diagnostic methods. About 10-15% of the aortic dissection patients are accompanied by changes in the ST segment by the dissecting flap of the coronary opening, which can lead to delayed diagnosis of aortic dissection, or can adversely affect the patient by administration to unnecessary drugs such as nitroglycerin, thrombolytic agent, and anticoagulants. It is difficult to distinguish aortic dissection from an acute myocardial infarction only through a 12-Lead electrocardiogram at the pre-hospital. The application of cardiac ultrasonography through medical direction to chest pain patients who show ST segmental changes in pre-hospital phase will contribute to the diagnosis of aortic dissection and the improvement of survival rate, such as anticoagulant administration, to patients with acute myocardial infarction.
Keywords
STEMI; Chest pain; Aortic dissection; STEMI equivalent; Left main coronary artery occlussion;
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