BMJ Case Reports 2018; doi:10.1136/bcr-2018-225307
  • Reminder of important clinical lesson

Cardiac arrest due to critical stenosis of a bicuspid aortic valve mimicking left main coronary artery occlusion on ECG

  1. Gregory Crooke
  1. Department of Cardiology, Maimonides Medical Center, Brooklyn, New York, USA
  1. Correspondence to Dr Abhinav Saxena, ASaxena{at}
  • Accepted 22 August 2018
  • Published 3 October 2018


A 49-year-old man presented to the emergency room after a cardiac arrest. On arrival, the patient’s ECG showed ST-segment elevations in the aVR and anteroseptal leads with diffuse ST depression suggestive of left main coronary artery occlusion. Subsequent coronary catheterisation showed normal coronaries but revealed severe stenosis of his bicuspid aortic valve. A surgical replacement of the aortic valve was performed, and the patient recovered successfully.


  • Contributors AS, NS, BT and GC: contributed to the formulation of the manuscript. BT and GC: reviewed and provided critical feedback on the manuscript before submission.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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