Failure of CT angiogram to detect an ascending aortic dissection

2018 ◽  
Vol 33 (4) ◽  
pp. 194-195
Author(s):  
Ahmad Masri ◽  
Valentino Bianco ◽  
Arman Kilic ◽  
Thomas G. Gleason ◽  
Ibrahim Sultan
Keyword(s):  
Aortic Dissection ◽  
Ct Angiogram

scholarly journals Traumatic aortic root rupture leading to acute aortic insufficiency and acute Type A aortic dissection.

2021 ◽  
Author(s):  
Subash Nepal ◽  
Vijay Raj ◽  
Debanik Chaudhuri ◽  
Stephany Barreto
Keyword(s):  
Aortic Dissection ◽  
Aortic Root ◽  
Type A ◽  
Aortic Insufficiency ◽  
Pulmonary Contusion ◽  
Acute Type ◽  
Multiple Fractures ◽  
Type A Aortic Dissection ◽  
Cardiac Symptoms ◽  
Ct Angiogram

A 17-year-old male was admitted for the management of multiple fractures after sustaining blunt thoracic trauma. He was hemodynamically stable and without any cardiac symptoms. He was admitted with fracture of T4 end plate, manubrium and left first rib, right pulmonary contusion, left apical pneumothorax and pneumomediastinum. The patient underwent echocardiography and cardiac CT angiogram for the work up of aortic injury as the patient had new aortic regurgitation murmur, troponin rise and RBBB. He was found to have aortic root rupture, type A aortic dissection and acute severe aortic insufficiency. The patient underwent surgical aortic valve and root replacement with Bentall procedure with good outcome.

scholarly journals Intravenous tPA in the treatment of acute stroke related to aortic dissection

2019 ◽  
Vol 12 (6) ◽  
pp. e229982
Author(s):  
Vikram Shivkumar ◽  
Dipali Nemade
Keyword(s):  
Aortic Dissection ◽  
Cerebral Hemisphere ◽  
Acute Onset ◽  
Medical Illness ◽  
Not Given ◽  
Ct Angiogram ◽  
Right Cerebral Hemisphere ◽  
Tissue Plasminogen ◽  
The Right ◽  
Time Of Presentation

A 61-year-old woman with no prior medical illness presented with acute onset stroke symptoms. She had no chest pain at the time of presentation. However, CT angiogram showed an extensive aortic dissection, resulting in hypoperfusion of the right cerebral hemisphere and thus causing stroke symptoms. Due to this finding, tissue plasminogen activator was not given and a negative outcome was avoided.

scholarly journals Penetrating Atheromatous Ulcer as a Precursor of Aortic Dissection: A Case Report

2020 ◽  
Author(s):  
Priya Shah ◽  
Erik Polan
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Ulcer Patient ◽  
Intramural Hematoma ◽  
Ascending Aorta ◽  
Current Case ◽  
Penetrating Aortic Ulcer ◽  
Ct Angiogram ◽  
Acute Aortic Syndromes ◽  
Life Threatening

Abstract Background: Acute aortic syndromes include a range of life-threatening conditions with the most familiar entity being aortic dissection. However, variants of aortic dissection also include intimal tear without hematoma, aortic intramural hematoma, and lastly penetrating aortic ulcer (PAU), which will be the focus of this case report. Most PAUs are located in the descending thoracic aorta (85-95%), but they can also occur in the ascending aorta or arch as in the current case.Case Presentation: We report a case of a 77 year old male who presented with chief complaint of intermittent right-handed weakness associated with no numbness or mental status changes. Patient was admitted for stroke workup with unrevealing findings on CT (computed tomography) for acute abnormalities or any hemodynamically significant stenosis on carotid ultrasound. CT angiogram of head/neck revealed a penetrating aortic ulcer of the lateral aspect of the mid to distal ascending aorta. Patient was then transferred for further evaluation to a center of higher level care for further management.Conclusions: Patient was evaluated for surgical repair of penetrating ascending aortic ulcer. Patient underwent serial imaging throughout hospital course which showed grossly similar findings to prior examination and thus no surgical intervention was needed at that time. Patient was recommended to have follow up CT scan in one month to monitor progression of aortic ulcer. Penetrating aortic ulcers are rarely located in the ascending aorta and are considered precursors of life-threatening aortic dissections.

Abstract 1757: A 35-Year-Old Female with Anterior ST Segment Elevation and Cardiogenic Shock

Circulation ◽  
2007 ◽  
Vol 116 (suppl_16) ◽  
Author(s):  
Marc Bonaca ◽  
David Morrow ◽  
Carolyn Ho
Keyword(s):  
Genetic Testing ◽  
Aortic Dissection ◽  
Aortic Root ◽  
Intramural Hematoma ◽  
Splice Acceptor Site ◽  
Unknown Etiology ◽  
Acceptor Site ◽  
Tall Stature ◽  
Left Main ◽  
Ct Angiogram

A 35 year-old female with history of spontaneous pneumothorax presented with acute onset chest pain. She was hypotensive and tachycardic. Exam revealed tall stature, distended neck veins, and diffuse crackles. CXR showed pulmonary edema, no pneuomothorax and normal cardiac and mediastinal silhouettes. Electrocardiogram showed antero-lateral ST elevation. The patient was intubated and stabilized. Transthoracic echocardiogram showed anterior wall motion abnormality, no pericardial effusion, a normal aortic root with no obvious dissection or aortic insufficiency. CT angiogram of the chest showed no aortic dissection. As no dissection was identified she was taken for cardiac catheterization for acute MI. Angiography revealed a patent right coronary and an occluded left-main. The left-main was successfully treated with angioplasty and stenting. Subsequent TEE revealed an aortic intramural hematoma adjacent to the left-main ostium. Repeat CT angiography revealed non-flow limiting dissections of the left subclavian, the superficial mesenteric, and the left internal carotid arteries. Her body habitus and presentation suggested a malignant connective tissue disorder. Family history included maternal fatal aortic rupture at age 40 and sudden death of her maternal grandfather at age 45 of unknown etiology. In addition to Marfan Syndrome, her aortic dissection without aortic dilation suggested a possible TGF-B receptor mutation (Loeys-Dietz syndrome). Genetic testing revealed a novel Fibrillin-1 mutation at intron 40. The location at the splice acceptor site of the intron/exon boundary was likely to be pathogenic. Her daughter has tall stature and normal aortic root and is undergoing mutation confirmation testing. The phenotypic characteristics of patients with Marfan and related syndromes may vary and are associated with important morbidity and mortality. Basic science and clinical translational studies have advanced our understanding of disease pathogenesis and our approach to patient care. Genetic testing offers potential for definitive identification of family members at risk. Illumination of the role of TGF-beta signaling in the pathobiology of these syndromes has led to new possibilities in treatment and diagnosis.

scholarly journals Penetrating Atheromatous Ulcer As A Precursor Of Aortic Dissection: A Case Report

2020 ◽  
Author(s):  
Priya Shah ◽  
Erik Polan
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Ulcer Patient ◽  
Intramural Hematoma ◽  
Ascending Aorta ◽  
Penetrating Aortic Ulcer ◽  
Ct Angiogram ◽  
Acute Aortic Syndromes ◽  
Life Threatening

Abstract Background: Acute aortic syndromes include a range of life-threatening conditions with the most familiar entity being aortic dissection. However, variants of aortic dissection also include intimal tear without hematoma, aortic intramural hematoma, and lastly penetrating aortic ulcer (PAU), which will be the focus of this case report. Most PAUs are located in the descending thoracic aorta (85-95%), but they can also occur in the ascending aorta or arch as in the current case. Case Presentation: We report a case of a 77 year old male who presented with chief complaint of intermittent right-handed weakness associated with no numbness or mental status changes. Patient was admitted for stroke workup with unrevealing findings on CT (computed tomography) for acute abnormalities or any hemodynamically significant stenosis on carotid ultrasound. CT angiogram of head/neck revealed a penetrating aortic ulcer of the lateral aspect of the mid to distal ascending aorta. Patient was then transferred for further evaluation to a center of higher level care for further management. Conclusions: Patient was evaluated for surgical repair of penetrating ascending aortic ulcer. Patient underwent serial imaging throughout hospital course which showed grossly similar findings to prior examination and thus no surgical intervention was needed at that time. Patient was recommended to have follow up CT scan in one month to monitor progression of aortic ulcer, however patient lost to follow-up thereafter. Penetrating aortic ulcers are rarely located in the ascending aorta and are considered precursors of life-threatening aortic dissections.

Motion Artifact Resulting in a False Positive CT Angiogram for a Presumed Aortic Dissection

2011 ◽  
Vol 26 (2) ◽  
pp. 223-224 ◽  
Author(s):  
Riny Karras ◽  
Marco Ricci ◽  
Thomas A. Salerno ◽  
Edward Gologorsky
Keyword(s):  
Aortic Dissection ◽  
False Positive ◽  
Motion Artifact ◽  
Ct Angiogram

A dreadful sign of aortic dissection: Aortic intimo-intimal intussusception with prominent intimal flap prolapsing into the left ventricular apex

VASA ◽  
2009 ◽  
Vol 38 (2) ◽  
pp. 181-184 ◽  
Author(s):  
Ozer ◽  
Davutoglu ◽  
Burma ◽  
Sucu ◽  
Sarı
Keyword(s):  
Aortic Dissection ◽  
Clinical Presentation ◽  
Left Ventricular ◽  
Left Ventricular Cavity ◽  
Acute Type ◽  
Clinical Form ◽  
Intimal Flap ◽  
Acute Type A Dissection ◽  
Type A Dissection ◽  
Intimal Intussusception

Intimo-intimal intussusception is an unusual clinical form of aortic dissection resulting from circumferential detachment of the intima. Clinical presentation varies according to the level of detached intima in the aorta. We present a case of acute type A dissection with prominent prolapse of the circumferential detachment intimal flap into the left ventricular cavity extended to the apex.

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