BMJ Case Reports 2013; doi:10.1136/bcr-2012-007962

Aortic arch variant presenting as an acute ST elevation myocardial infarction

  1. Syed Hassan
  1. Henry Ford Hospital, Detroit, Michigan, USA
  1. Correspondence to Dr Zaid Alirhayim, zaid_md{at}


A woman in her 40s presented to our institution with a first episode of sudden-onset right-sided chest pain. Initially, her ECG revealed ST segment elevation in leads V1–V3 and cardiac biomarkers were elevated with a troponin I (TnI) 5 µg/l. Her cardiac risk factors included type II diabetes mellitus and a history of hypertension. Intravenous heparin was initiated and emergent cardiac catheterisation revealed non-obstructive coronary artery disease. A two-dimensional echocardiogram confirmed hypokinesis of the anterior wall. A CT thorax demonstrated a rare anatomical variant of the aortic arch with an aberrant right subclavian artery. This is a rare case of an aortic arch anomaly presenting as a myocardial infarction.

Register for free content

The full text of all Editor's Choice articles and summaries of every article are free without registration

The full text of Images in ... articles are free to registered users

Only fellows can access the full text of case reports (apart from Editor's Choice) - become a fellow today, or encourage your institution to, so that together we can grow and develop this resource

Don't forget to sign up for content alerts so you keep up to date with all the case reports as they are published, and let us know what you think by commenting on the Editor's blog

Navigate This Article