Coronary artery dissection: Difference between revisions
Neil.m.young (talk | contribs) (Text replacement - "==Diagnosis==" to "==Evaluation==") |
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*Hormonal changes in vessel wall | *Hormonal changes in vessel wall | ||
*Shear forces | *Shear forces | ||
*Underling connective tissue | *Underling [[connective tissue disorder]] | ||
==Clinical Features== | ==Clinical Features== | ||
Revision as of 22:30, 9 November 2016
Background
- Usually presents as an Anterior MI with ST changes in anterior Precordial leads (V1-V3)
Causes
- Hormonal changes in vessel wall
- Shear forces
- Underling connective tissue disorder
Clinical Features
Differential Diagnosis
ST Elevation
- Cardiac
- ST-segment elevation myocardial infarction (STEMI)
- Post-MI (ventricular aneurysm pattern)
- Previous MI with recurrent ischemia in same area
- Wellens' syndrome
- Coronary artery vasospasm (eg, Prinzmetal's angina)
- Coronary artery dissection
- Pericarditis
- Myocarditis
- Aortic dissection in to coronary
- Left ventricular aneurysm
- Left ventricular pseudoaneurysm
- Early repolarization
- Left bundle branch block
- Left ventricular hypertrophy (LVH)
- Myocardial tumor
- Myocardial trauma
- RV pacing (appears as Left bundle branch block)
- Brugada syndrome
- Takotsubo cardiomyopathy
- AVR ST elevation
- Other thoracic
- Metabolic
- Drugs of abuse (eg, cocaine, crack, meth)
- Hyperkalemia (only leads V1 and V2)
- Hypothermia ("Osborn J waves")
- Medications