Infarction-like electrocardiogram during aortic dissection

A clinical example demonstrates the difficulties of differential diagnosis of infarct-like ECG during aortic dissection. The difficulty of diagnosis was the absence of pain, impaired consciousness of the patient, the presence of anisocoria, ECG changes simulating acute myocardial infarction with ST segment elevation, and the presence of obstructive changes in the coronary arteries according to the results of coronary angiography. The diagnosis was initially confirmed by aortography, then by multislice computed tomography of the aorta and echocardiography. Possible clinical diagnostic signs of aortic dissection are given.