Penetrating Atherosclerotic Ulcer with Elevated Troponin in A Patient with Old Myocardial Infarction: A Case Report  

作　　者：Peiyao Ma Shenke Kong Kun Wang Xin Wang Xuejun Zhang Dandan Li Qiang Zhao Fayun Zhao Xiangdong Zhou Shuai Ji 

机构地区：[1]Henan Provincial Chest Hospital,Zhengzhou 450000,Henan Province,China

出　　处：《Journal of Clinical and Nursing Research》2022年第3期146-150,共5页临床护理研究（英文）

基　　金：2018 Joint Construction Project of Henan Medical Science and Technology Research Plan(Project Number:2018020541)。

摘　　要：Penetrating atherosclerotic ulcer(PAU),an uncommon etiology of acute aortic syndrome(AAS),is a potential cause of chest pain seen in emergency departments.As PAU may lead to electrocardiogram(ECG)changes or rarely,elevated troponin levels,it is most likely misdiagnosed as acute coronary syndrome(ACS).Hence,individuals with PAU may be offered potentially life-threatening treatment.This paper reports a case of a 81-year-old male who presented with intermittent chest pain with a history of old inferior myocardial infarction and stent placement in the left circumflex coronary artery(LCX)three years ago.Initially,he was diagnosed with non-ST-elevation myocardial infarction(NSTEMI)based on abnormal ECG changes and raised troponin I.However,emergency coronary angiography(CAG)showed no restenosis in the left circumflex coronary artery(LCX)but with mild stenosis in the left anterior descending artery(LAD)and right coronary artery(RCA).Computed tomographic angiography(CIA)of the whole aorta showed multiple atherosclerotic plaques with penetrating atherosclerotic ulcer in the aortic arch and descending aorta.Endovascular aortic repair with Ankura II covered stent was performed.This case study reminds us that it is clinically difficult to distinguish PAU from ACS.Upon excluding ACS from the diagnosis,we should take into consideration of PAU,especially in elderly patients with positive cTnI.

关 键 词：Penetrating atherosclerotic ulcer Non-ST-elevation myocardial infarction Elevated troponin Acute aortic syndrome 

分 类 号：R54[医药卫生—心血管疾病]