Diagnostic Pitfalls in Aortic Dissection: A Case of Misdiagnosed Acute Myocardial Infarction Leading to Emergency Surgical Intervention

Abstract

Background: The defining feature of aortic dissection (AD), a life-threatening cardiovascular emergency, is an intimal tear in the aortic wall that creates a false lumen. Early detection remains challenging because symptoms frequently resemble those of other acute cardiovascular conditions despite medical and surgical treatment advances.

Case Presentation: We report the case of a 52-year-old male with newly diagnosed hypertension and diabetes mellitus who initially presented with severe chest pain and was misdiagnosed with acute myocardial infarction. He received thrombolytic therapy and was discharged, only to return days later with recurrent chest pain radiating to the abdomen. Stanford Type A aortic dissection affecting the aortic root and arch was confirmed through diagnostic imaging with echocardiography and computed tomography angiography (CTA). Emergency surgery on the patient involved replacing the aortic root and hemi-arch and repairing the aortic valve along with performing coronary artery bypass grafting.

Conclusion: This case demonstrates the diagnostic complexities of AD when its early symptoms resemble those of acute coronary syndrome. Due to the significant risks of delayed diagnosis, clinicians need to remain alert to the possibility of AD when patients show up with severe, sudden chest pain. Successful patient results depend on prompt imaging and surgical procedures.