Cath-Lab Clues to Type A Aortic Dissection Presenting as Acute Myocardial Infarction.

IMAGE(S): Emergency coronary angiography and computed tomography angiography showing catheterization laboratory (Cath-Lab) clues to type A aortic dissection presenting as acute myocardial infarction. CASE SUMMARY: A 67-year-old man underwent emergency angiography for anterior ST-segment elevation. Difficult coronary engagement, thin strip-like left coronary narrowing, and marked catheter swing prompted reassessment. Computed tomography angiography confirmed type A aortic dissection involving the left main ostium, and unnecessary percutaneous coronary intervention was avoided. Five recurring angiographic warning clues are summarized. TAKE-HOME MESSAGES: These 5 practical Cath-Lab clues would help you away from emergency type A aortic dissection trap. Timely recognition of Cath-Lab clues and pause; activate the aortic surgical team.