Journal of cardiothoracic surgery · 2024
Exceptionally rare MINOCA: a case of acute myocardial infarction following surgery for Stanford type A aortic dissection.
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Chen Miaoyun, Hao Junhai, Zhang Chongjian
Аннотация
BACKGROUND: Aortic dissection is a severe cardiovascular condition associated with high mortality rates, particularly in cases of Stanford type A aortic dissection (TAAD). Myocardial infarction with non-obstructive coronary arteries (MINOCA) following surgery for TAAD is rare but potentially fatal.
CASE PRESENTATION: A 69-year-old woman presented with sudden chest pain and was diagnosed with acute TAAD. Emergency surgery was performed, during which complications arose, including significant hemodynamic instability. Despite efforts to manage the patient's condition postoperatively, she developed hemodynamic instability and myocardial infarction, leading to cardiogenic shock. MINOCA was diagnosed based on clinical presentation, echocardiographic findings, and coronary angiography ruling out significant stenosis or occlusion. The patient's condition deteriorated despite aggressive treatment, ultimately resulting in death.
CONCLUSION: MINOCA following surgery for TAAD is a rare but serious complication. Vigilant postoperative monitoring and timely intervention are essential for identifying and managing acute cardiac dysfunction in these patients. Further research is required to improve outcomes in this challenging clinical scenario.
CASE PRESENTATION: A 69-year-old woman presented with sudden chest pain and was diagnosed with acute TAAD. Emergency surgery was performed, during which complications arose, including significant hemodynamic instability. Despite efforts to manage the patient's condition postoperatively, she developed hemodynamic instability and myocardial infarction, leading to cardiogenic shock. MINOCA was diagnosed based on clinical presentation, echocardiographic findings, and coronary angiography ruling out significant stenosis or occlusion. The patient's condition deteriorated despite aggressive treatment, ultimately resulting in death.
CONCLUSION: MINOCA following surgery for TAAD is a rare but serious complication. Vigilant postoperative monitoring and timely intervention are essential for identifying and managing acute cardiac dysfunction in these patients. Further research is required to improve outcomes in this challenging clinical scenario.