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Case Reports
. 2024 Jan-Dec:12:23247096241264634.
doi: 10.1177/23247096241264634.

Aortic Aneurysm Mimicking Inferior ST-Elevation Myocardial Infarction: A Case Report

Ahmed Qasim Mohammed Alhatemi  1 , Ezzat Mohammed Hussain Aziz  2 , Amjed Hussein Alwan Al-Yaseen  2 , Hashim Talib Hashim  3 , Zaid Haitham Abduljabbar  2 , Salwan Qahtan Sultan  2 , Tiba Khalid Abdulhussain  1 , Rand Abdulhussain  4
Affiliations
Case Reports

Aortic Aneurysm Mimicking Inferior ST-Elevation Myocardial Infarction: A Case Report

Ahmed Qasim Mohammed Alhatemi et al. J Investig Med High Impact Case Rep. 2024 Jan-Dec.

Abstract

Here, we report a rare case of a 22-year-old female presenting with recurrent chest pain mimicking inferior ST-elevation myocardial infarction (STEMI) but ultimately attributed to an aortic aneurysm. Despite facing initial challenges in diagnosis, such as normal troponin levels and temporary electrocardiogram (ECG) changes, advanced imaging showed a large mass in the chest pressing on the right coronary artery. Prompt multidisciplinary intervention, including surgical resection of the aneurysm, led to successful management and improved outcomes. This case highlights the importance of considering unusual etiologies in atypical presentations of myocardial infarction, necessitating comprehensive evaluation and collaboration among various specialties for optimal patient care.

Keywords: cardiology; cardiothoracic surgery; emergency medicine; radiology and imaging.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Figures

Figure 1.
Figure 1.
Emergency ECG showing ST-segment elevation at leads II, III, and aVF with reciprocal ST-segment depression at lead aVL.
Figure 2.
Figure 2.
ECG 30 minutes after presentation at the tertiary cardiac hospital revealing normal ST segment and sinus rhythm.
Figure 3.
Figure 3.
Chest X-ray PA view showing large mediastinal mass.
Figure 4.
Figure 4.
(A) Coronary angiography showing normal right coronary artery RCA blood flow (red arrow). (B) Normal left anterior deciding artery LAD (red arrow) and left circumflex artery LAD (white arrow) blood flow.
Figure 5.
Figure 5.
Aortic injection using a Judkins left (JL) catheter shows a sac behind the ascending aorta, aortic arch, and descending aorta.
Figure 6.
Figure 6.
Chest CT angiogram revealing well-defined anterior mediastinal soft tissue density lesion of about 84.9 × 67.2 mm seen at aorto-pulmonary window with mass effect compression of the main pulmonary artery and proximal ascending aorta (red arrows and cross).
Figure 7.
Figure 7.
Aortic defect near sinus of valsalva after aneurysm resection.
Figure 8.
Figure 8.
Aneurysm tissue sample after resection.
Figure 9.
Figure 9.
Aortic interposition graft placement.
See this image and copyright information in PMC

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