Issue |
Med Buccale Chir Buccale
Volume 16, Number 3, juillet 2010
|
|
---|---|---|
Page(s) | 189 - 190 | |
Section | Observations cliniques / Case reports | |
DOI | https://doi.org/10.1051/mbcb/2010022 | |
Published online | 12 July 2010 |
Observation clinique
Syndrome coronarien aigu : risque d’erreur diagnostique. A propos d’un cas
Acute coronary syndrome : risk of missed diagnosis. A case report
1
Département de Médecine buccale et de Chirurgie buccale, Faculté de
Chirurgie dentaire Paris Descartes, Paris, France
2
Service d’Accueil des Urgences, Hôpital Lariboisière,
Paris, France
3
Service de Réanimation chirurgicale, Groupe hospitalier Bichat - Claude
Bernard, Paris,
France
* Correspondance:
florian.laurent@free.fr
Reçu :
12
Avril
2010
Accepté :
21
Avril
2010
Classiquement, les syndromes coronariens aigus se manifestent par une douleur thoracique rétrosternale, constrictive et irradiante. Toutefois, chez certains patients, il peut exister des manifestations atypiques, notamment chez les personnes âgées. De plus, certains infarctus peuvent simuler un malaise vagal.
Nous présentons le cas d’un homme de 87 ans qui, arrivant chez son chirurgien dentiste, fait un malaise de type vagal avec pâleur, sueurs, bradycardie et hypotension, sans douleur thoracique ni dyspnée. L’électrocardiogramme a permis de diagnostiquer un infarctus étendu du myocarde antérieur.
Tout chirurgien dentiste devrait savoir qu’un malaise vagal ne cédant pas aux premières mesures peut être révélateur d’un syndrome coronarien aigu.
Abstract
Acute coronary syndrome (ACS) can occur in dental offices. Usually, their manifestations are typical such as radiating chest pain, shortness of breath or sweating, but atypical symptoms or unusual presentations may occur notably in the elderly population. Also, some ACS like inferior infarction may be misdiagnosed as a vasovagal syncope.
We report the case of a 87 year-old man coming to dental office. While arriving at the dental office he presented faintness with sweating and palor. He did not complain of chest pain or dyspnea. On examination, he presented bradycardia and hypotension. Anamnesis found hypertension but no coronary disease. The presentation was like typical vasovagal syncope. Finally, an electrocardiogram diagnose an important anterior myocardial infarction.
Vasovagal syncope is the most common emergency in dental office. Dental surgeon must be careful when this kind of faintness occur notably in elderly.
Mots clés : syndrome coronarien aigu / urgence médicale / patient âgé / malaise vagal
Key words: acute coronary syndrome / medical emergency / elderly / vasovagal syncope
© SFMBCB, 2010
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