# Acute myocardial infarction due to type A aortic dissection in a patient with corrected congenital cardiopathy: a case report

## TL;DR

A young man with corrected congenital heart disease had a heart attack caused by a rare aortic dissection, highlighting the need for careful diagnosis.

## Contribution

This case report highlights a rare presentation of aortic dissection as acute myocardial infarction in a patient with congenital heart disease.

## Key findings

- Aortic dissection can mimic acute myocardial infarction, especially in patients with congenital heart disease.
- Extrinsic compression of the coronary artery by an aortic aneurysm may cause myocardial infarction.
- Imaging is crucial for diagnosing aortic dissection in patients presenting with chest pain.

## Abstract

Ascending aortic dissection rarely presents as acute myocardial infarction, and when it does, its diagnosis is even more challenging.

We present a case of a young male with corrected congenital heart disease and a giant ascending aorta aneurysm. He was admitted to hospital for chest pain and was diagnosed with acute anterior myocardial infarction. Imaging tests showed dissection of the ascending aorta. He required complex cardiovascular surgery for Dacron tube implantation to treat the giant ascending aortic aneurysm.

This case is a reminder of how important adequate differential diagnosis is in the context of myocardial infarction, as well as the management of acute aortic syndrome. In our patient, the patency of the left coronary artery was verified using imaging techniques, and the most likely cause of the infarction could be the aneurysm extrinsically compressing the coronary artery.