ST elevation in lead aVR with malperfusion syndrome: sign of severe aortic dissection
Aortic dissection presenting with ST elevation in lead aVR of electrocardiogram is strongly associated with mortality. It is also associated with dissection involving the root of aorta and coronary vessels. We report a case of young male with hypertension, who presented with severe chest pain and...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Pusat Perubatan Universiti Kebangsaan Malaysia
2020
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| Online Access: | http://journalarticle.ukm.my/16289/ http://journalarticle.ukm.my/16289/1/26_ms0346_pdf_89171.pdf |
| _version_ | 1848814014669258752 |
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| author | Azlan Helmy Abd Samat, Ida ZZ, Yat, Keong Y Isa MH, |
| author_facet | Azlan Helmy Abd Samat, Ida ZZ, Yat, Keong Y Isa MH, |
| author_sort | Azlan Helmy Abd Samat, |
| building | UKM Institutional Repository |
| collection | Online Access |
| description | Aortic dissection presenting with ST elevation in lead aVR of electrocardiogram
is strongly associated with mortality. It is also associated with dissection involving
the root of aorta and coronary vessels. We report a case of young male with
hypertension, who presented with severe chest pain and unilateral lower limb pain. Physical examination of the left lower limb was consistent with acute limb
ischemia. Electrocardiogram revealed acute anterolateral myocardial infarction
together with ST elevation in aVR. Bedside transthoracic echocardiography
showed a dilated aortic root measuring 4.51 cm with presence of intimal flap
which raised the suspicion of dissection of root of aorta and left coronary artery.
Computed tomography angiogram revealed aortic dissection from the root of
aorta including the intimal flap near the origin of the left coronary artery, down
to common iliac extending to the left iliac artery. Unfortunately, the patient opted
for non-surgical intervention and succumbed 48 hours later. This case highlights
that in case of aortic dissection, which presents with malperfusion syndrome,
the presence of ST segment elevation at lead aVR should raise the suspicion for
extensive aortic dissection involving the aortic root and left coronary artery which
signifies unfavourable outcome. |
| first_indexed | 2025-11-15T00:27:21Z |
| format | Article |
| id | oai:generic.eprints.org:16289 |
| institution | Universiti Kebangasaan Malaysia |
| institution_category | Local University |
| language | English |
| last_indexed | 2025-11-15T00:27:21Z |
| publishDate | 2020 |
| publisher | Pusat Perubatan Universiti Kebangsaan Malaysia |
| recordtype | eprints |
| repository_type | Digital Repository |
| spelling | oai:generic.eprints.org:162892021-03-16T01:37:41Z http://journalarticle.ukm.my/16289/ ST elevation in lead aVR with malperfusion syndrome: sign of severe aortic dissection Azlan Helmy Abd Samat, Ida ZZ, Yat, Keong Y Isa MH, Aortic dissection presenting with ST elevation in lead aVR of electrocardiogram is strongly associated with mortality. It is also associated with dissection involving the root of aorta and coronary vessels. We report a case of young male with hypertension, who presented with severe chest pain and unilateral lower limb pain. Physical examination of the left lower limb was consistent with acute limb ischemia. Electrocardiogram revealed acute anterolateral myocardial infarction together with ST elevation in aVR. Bedside transthoracic echocardiography showed a dilated aortic root measuring 4.51 cm with presence of intimal flap which raised the suspicion of dissection of root of aorta and left coronary artery. Computed tomography angiogram revealed aortic dissection from the root of aorta including the intimal flap near the origin of the left coronary artery, down to common iliac extending to the left iliac artery. Unfortunately, the patient opted for non-surgical intervention and succumbed 48 hours later. This case highlights that in case of aortic dissection, which presents with malperfusion syndrome, the presence of ST segment elevation at lead aVR should raise the suspicion for extensive aortic dissection involving the aortic root and left coronary artery which signifies unfavourable outcome. Pusat Perubatan Universiti Kebangsaan Malaysia 2020-12 Article PeerReviewed application/pdf en http://journalarticle.ukm.my/16289/1/26_ms0346_pdf_89171.pdf Azlan Helmy Abd Samat, and Ida ZZ, and Yat, Keong Y and Isa MH, (2020) ST elevation in lead aVR with malperfusion syndrome: sign of severe aortic dissection. Medicine & Health, 15 (2). pp. 297-305. ISSN 2289-5728 https://www.medicineandhealthukm.com/toc/15/2 |
| spellingShingle | Azlan Helmy Abd Samat, Ida ZZ, Yat, Keong Y Isa MH, ST elevation in lead aVR with malperfusion syndrome: sign of severe aortic dissection |
| title | ST elevation in lead aVR with malperfusion syndrome: sign of severe aortic dissection |
| title_full | ST elevation in lead aVR with malperfusion syndrome: sign of severe aortic dissection |
| title_fullStr | ST elevation in lead aVR with malperfusion syndrome: sign of severe aortic dissection |
| title_full_unstemmed | ST elevation in lead aVR with malperfusion syndrome: sign of severe aortic dissection |
| title_short | ST elevation in lead aVR with malperfusion syndrome: sign of severe aortic dissection |
| title_sort | st elevation in lead avr with malperfusion syndrome: sign of severe aortic dissection |
| url | http://journalarticle.ukm.my/16289/ http://journalarticle.ukm.my/16289/ http://journalarticle.ukm.my/16289/1/26_ms0346_pdf_89171.pdf |