Ziyu Zheng

A case report of acute myocardial infarction concomitant with Standford type B aortic dissection.

BACKGROUND Acute myocardial infarction (AMI) concomitant with aortic dissection (AD) is rare but a devastating situation if misdiagnosed as simply AMI, followed by anticoagulant or thrombolytic therapy. In such cases, Standford type B AD was extremely infrequent. OBJECTIVES To present a case with apparent concordance with the patients history, symptoms, cardiac enzymes that lead to diagnostic error. CASE REPORT An 85-year-old man with chronic hypertension and coronary atherosclerotic heart disease presented in our emergency department with squeezing retrosternal chest pain and dyspnea. Elevated cardiac enzymes and electrocardiography result suggested acute non-ST-segment elevation myocardial infarction. Emergency coronary angiography demonstrated a 50-90% diffuse stenosis of the proximal and mid right coronary artery also confirmed the diagnosis. Stents were deployed thereafter. However, the patient was found to be concomitant with Standford type B AD by computed tomography angiography due to unrelieved chest pain and new onset of abdominal pain after the operation. The patient refused to have endovascular operation and died of hemorrhagic shock one week later. CONCLUSIONS AD may cause AMI due to some indirect mechanisms, and it is of utmost importance to search for the existence of AD before reperfusion therapy in AMI patients. Aortic dissection detection risk score, transthoracic echocardiography and D-dimer help early identification of AD.

GW29-e1717 Point of care ultrasound in chest pain center: a feasibility study

Ultrasound plays a central role in diagnosis and triage in emergency patients and extends its application to potential critical situations such as chest pain. The aim of our study is to evaluate the feasibility of point of care ultrasound (POCUS) in chest pain center. During 3 months, 97 chest pain

GW29-e1442 Effect of evaluating the quality of chest compression by bedside ultrasound during cardiopulmonary resuscitation in cardiac arrest patients

To study the effectiveness of bedside ultrasound in evaluating the quality of chest compression during CPR and predict the resuscitation outcomes. During cardiopulmonary resuscitation in 29 patients, bedside ultrasound monitoring of unilateral common carotid artery recorded the data of blood flow