Aortic Dissection with Subsequent Hemorrhagic Tamponade Diagnosed with Point-of-care Ultrasound in a Patient Presenting with STEMI

Eric Abrams; Angela Allen; Shadi Lahham

doi:10.5811/cpcem.2019.1.40869

Aortic Dissection with Subsequent Hemorrhagic Tamponade Diagnosed with Point-of-care Ultrasound in a Patient Presenting with STEMI

Clin Pract Cases Emerg Med. 2019 Feb 26;3(2):103-106. doi: 10.5811/cpcem.2019.1.40869. eCollection 2019 May.

Authors

Eric Abrams¹, Angela Allen², Shadi Lahham¹

Affiliations

¹ University of California, Irvine, Department of Emergency Medicine, Orange, California.
² University of California, Irvine, School of Medicine, Irvine, California.

Abstract

A 58-year-old male with no past medical history presented to the emergency department with sudden onset left lower extremity weakness and central chest pain with radiation to his back. Electrocardiogram revealed an acute inferior and posterior ST-segment elevation myocardial infarction (STEMI). Point-of-care ultrasound (POCUS) demonstrated right ventricular akinesis consistent with infarction, and an intimal defect consistent with an aortic dissection. We determined that cardiothoracic surgery was indicated rather than left-heart catheterization and anticoagulation. Using POCUS we were able to immediately diagnose a dissection of the aortic arch and considerably alter treatment in a patient presenting with STEMI.

Publication types

Case Reports