Acute Aneurysm (dissection) mimics which cardiac event?

• A. Angina
• B. Heart failure
• C. Acute MI
• D. Atrial fibrillation

Answer: (C)

Acute aortic dissection can present with chest pain and ECG/troponin changes that closely resemble an acute myocardial infarction. The dissection can extend to the coronary ostia and cause myocardial ischemia, producing changes on the ECG and elevated cardiac biomarkers similar to an MI. This overlap in presentation is why the scenario is often mistaken for an acute MI, making the distinction crucial because the underlying problem is aortic pathology, not coronary artery occlusion.

Briefly, while angina can cause chest pain, it usually lacks the sudden, severe, potentially tearing quality and rapid progression seen with dissection and may not produce the same dramatic ECG/troponin findings. Heart failure centers on symptoms like dyspnea and edema rather than abrupt chest pain with MI-like ECG changes. Atrial fibrillation presents with irregular pulse and palpitations rather than the chest pain and ischemic ECG/biomarker pattern typical of MI.