ArticleCureus2025
A Case of Severe Aortic Stenosis Mimicking Acute Coronary Syndrome: Diagnostic Challenges and Surgical Management.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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4 authors.
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Abstract
Chest pain with elevated troponin and ECG changes often prompts a diagnosis of acute coronary syndrome (ACS). However, this presentation can mask other critical pathologies. We report a case of a 52-year-old male who presented with exertional chest discomfort and progressive dyspnea. Initial workup, including troponin elevation and lateral ST-segment depression, led to a presumptive diagnosis of ACS. However, further imaging revealed severe aortic stenosis (AS) secondary to a bicuspid aortic valve (BAV), with a significantly dilated ascending aorta. Intraoperatively, an annular abscess was discovered beneath the right coronary cusp, confirming a missed diagnosis of infective endocarditis (IE). The patient underwent a successful Bentall procedure with aortic root and valve replacement. This case illustrates the diagnostic challenge posed by overlapping cardiovascular pathologies and emphasizes the importance of thorough evaluation in patients with atypical ACS presentations, particularly when structural heart disease is suspected.
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