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

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}live.com

Summary

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.

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