Acute dysfunction of mechanical aortic valve as electrocardiographic mimic of acute left main coronary artery occlusion.

Abstract

We report three patients with acute dysfunction of mechanical aortic valve prosthesis resulting in chest pain, concomitant cardiogenic shock, and electrocardiographic changes mimicking acute occlusion of the left main coronary artery whereas emergency coronary angiography revealed normal coronary arteries. During operation, abnormal proliferation of subvalvular pannus overgrowth on the inflow aspect of the prosthesis was found to impede normal prosthesis closure. We discuss the possible underlying mechanisms of electrocardiographic presentations.