Clues to the presence of aortic dissection along with myocardial infarction

Clues to the presence of aortic dissection along with myocardial infarction

Right coronary artery is more likely to be involved in aortic dissection than left coronary artery. Associated dissection would be a contraindication for thrombolytic therapy and can cause difficulty during attempted percutaneous coronary intervention. Hence it may be wise to look for aortic dissection in all cases of inferior wall myocardial infarction.

Careful assessment of peripheral pulses may pick up an asymmetry suggesting dissection, especially in a patient with chest pain radiating to back. A focussed echocardiography may be able to pick up the dissection flap in the proximal aorta. CT aortogram can eminently document dissection. Yet it needs high clinical suspicion to detect dissection and document it in a case presenting to the emergency department.