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Figures

Fig. 1

Electrocardiography showing signs of diffuse myocardial ischemia.

Fig. 2

A, Coronary angiography of the left coronary artery before PCI. Right anterior oblique with cranial angulation. B, Coronary angiography of the left coronary artery after PCI and stenting of the LMCA. Left anterior oblique with cranial angulation.

Fig. 3

A, Transesophageal echocardiography with visualization of an intimal flap. B, Transesophageal echocardiography with visualization of an intimal flap with an eccentric aortic regurgitation.

Diagnosing acute Stanford type A aortic dissection with the uncommon involvement of the left main coronary artery (LMCA) remains challenging for the emergency physician because it can resemble acute myocardial infarction with cardiogenic shock. The following case report illustrate this infrequent but critical situation. A 52-year-old woman with a history of hypertension awakened with acute retrosternal chest pain accompanied by nausea and vomiting. She was referred to our hospital for primary coronary intervention because of acute myocardial infarction with cardiogenic shock.

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