Xiao-Yu Zhou,Jing Xu.[J].中华创伤杂志英文版,2018,21(4):243-245
Misdiagnosed coronary artery diseaseeacute aortic syndrome: A case report
KeyWord: Acute aortic syndromeChest traumaTraffic accidents
Author NameAffiliation
Xiao-Yu Zhou Third Department of Cardiac Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China 
Jing Xu Third Department of Cardiac Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China 
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      It is estimated that 15% of traffic accidents cause trauma to large vessels. In about 70%e95% of cases, aortic rupture took place in the distal ligament of the left subclavian artery, whereas in the remaining cases rupture occurred in the ascending aorta above the aortic valve. Trauma to the aortic sinus and coronary arteries is rarely found in traffic accident victims. Therefore, coronary artery trauma is often misdiagnosed as coronary atherosclerotic heart disease. The present case is a 42 years old male who survived from a traffic accident. He presented with aortic sinus and left coronary artery trauma. He was misdiagnosed as having coronary atherosclerotic heart disease, and therefore wrongly given antiplatelet medicine, such as aspirin, in another hospital. Definite diagnosis was achieved in our hospital, and the patient underwent Bentall and mitral valve replacement, as well as tricuspid valvuloplasty. The aortic occlusion time during surgery was 47 min, and the total cardiopulmonary bypass time was 63 min. After surgery, transthoracic echocardiography confirmed that all the artificial valves worked sufficiently. The patient felt good and symptoms such as asthma and decreased exercise tolerance disappeared. This case taught us that acute aortic syndrome cannot be ignored when patients present with pectoralgia; antiplatelet medication should not be given before definite diagnosis.
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