scholarly journals Thoracic aortic dissection mistakenly diagnosed as pulmonary embolism: A potentially fatal error

2004 ◽  
Vol 3 (3) ◽  
pp. 114-116
Author(s):  
Namal Weerasuriya ◽  
◽  
Manika Jayawardena ◽  
J Snape ◽  
◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pleural Effusion ◽  
Aortic Dissection ◽  
Epigastric Pain ◽  
Delayed Diagnosis ◽  
Sudden Onset ◽  
Thoracic Aortic Dissection ◽  
Chest Infection ◽  
Strength Of Association

Thoracic aortic dissection may present in many different ways leading to delayed diagnosis, often with catastrophic results. We present a patient with sudden onset epigastric pain, breathlessness, fever and a left sided pleural effusion, who was initially treated for a chest infection, subsequently for pulmonary embolism, with a serendipitous diagnosis of aortic dissection eventually being made. The strength of association of pleural effusion and aortic dissection and the need for vigilance with regard to the diagnosis of aortic dissection is emphasised.

scholarly journals Aortic Dissection Presenting as Acute Pancreatitis: Suspecting the Unexpected

2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Adam Hafeez ◽  
Dillon Karmo ◽  
Adrian Mercado-Alamo ◽  
Alexandra Halalau
Keyword(s):  
Blood Pressure ◽  
Acute Pancreatitis ◽  
Aortic Dissection ◽  
Epigastric Pain ◽  
Pressure Control ◽  
Sudden Onset ◽  
Medical Emergency ◽  
Threatening Condition ◽  
Life Threatening ◽  
Normal Triglyceride

Aortic dissection is a life-threatening condition in which the inner layer of the aorta tears. Blood surges through the tear, causing the inner and middle layers of the aorta to separate (dissect). It is considered a medical emergency. We report a case of a healthy 56-year-old male who presented to the emergency room with sudden onset of epigastric pain radiating to his back. His blood pressure was 167/91 mmHg, equal in both arms. His lipase was elevated at 1258 U/L, and he was clinically diagnosed with acute pancreatitis (AP). He denied any alcohol consumption, had no evidence for gallstones, and had normal triglyceride level. Two days later, he endorsed new suprapubic tenderness radiating to his scrotum, along with worsening epigastric pain. A MRCP demonstrated evidence of an aortic dissection (AD). CT angiography demonstrated a Stanford type B AD extending into the proximal common iliac arteries. His aortic dissection was managed medically with rapid blood pressure control. The patient had excellent recovery and was discharged home without any surgical intervention.

scholarly journals Slowly Progressive and Painless Thoracic Aortic Dissection Presenting with a Persistent Fever in an Elderly Patient: The Usefulness of Combined Measurement of Biochemical Parameters

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Shunsuke Yamada ◽  
Masanori Tokumoto ◽  
Toshiaki Ohkuma ◽  
Yasuo Kansui ◽  
Yoshinobu Wakisaka ◽  
...  
Keyword(s):  
Chest Pain ◽  
Aortic Dissection ◽  
Medical Condition ◽  
Correct Diagnosis ◽  
Delayed Diagnosis ◽  
Clinical Manifestations ◽  
Unknown Origin ◽  
Sudden Onset ◽  
Proper Diagnosis ◽  
Typical Chest Pain

Aortic dissection is a fatal medical condition that requires urgent diagnosis and appropriate intervention. Because acute aortic dissection often manifests as sudden onset excruciating chest pain, physicians can easily reach a proper diagnosis. However, some patients with aortic dissection present with varied clinical manifestations without exhibiting typical chest pain, leading to a delayed diagnosis and possible fatality. We herein present the case of an elderly subject with a fever of unknown origin who was ultimately diagnosed with aortic dissection. In the present case, a negative procalcitonin test, increased D-dimer and serum creatinine phosphokinase-BB levels, and reelevation of the CPR level led us to the correct diagnosis.

Acute Type-A Aortic Dissection with Obstruction of the Right Coronary Artery

2014 ◽  
Vol 17 (4) ◽  
pp. 196
Author(s):  
Erhan Kaya ◽  
Halit Yerebakan ◽  
Daniel Spielman ◽  
Omer Isik ◽  
Cevat Yakut
Keyword(s):  
Coronary Artery ◽  
Aortic Dissection ◽  
Right Coronary Artery ◽  
Type A ◽  
Sudden Onset ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Coronary Syndrome ◽  
Bentall Procedure ◽  
The Right

Occlusion of a coronary artery by an acute type A aortic dissection presents a life-threatening emergency that is rarely seen and easy to misdiagnose. We present the case of a 75-year-old male who experienced sudden onset of severe left-sided chest pain due to an acute type A aortic dissection that obstructed the right coronary artery. Following an initial misdiagnosis of acute coronary syndrome, imaging revealed the presence of an aortic dissection. An emergency modified Bentall procedure was performed, in which the damaged aorta and aortic valve were replaced.

Ultrasound diagnosis of dissecting thoracic aortic aneurysms: procedure with a handheld device and a video-illustrated case

2021 ◽  
Vol 51 (1) ◽  
pp. 10-15
Author(s):  
Kenneth V Iserson ◽  
Sri Devi Jagjit ◽  
Balram Doodnauth
Keyword(s):  
Aortic Dissection ◽  
Correct Diagnosis ◽  
Signs And Symptoms ◽  
Aortic Aneurysms ◽  
Thoracic Aortic Aneurysms ◽  
Handheld Device ◽  
Thoracic Aortic Dissection ◽  
Threatening Condition ◽  
Life Threatening ◽  
Handheld Ultrasound

Acute thoracic aortic dissection is an uncommon, although not rare, life-threatening condition. With protean signs and symptoms that often suggest more common cardiac or pulmonary conditions, it can be difficult to diagnose. Ultrasound has proven useful in making the correct diagnosis. This case demonstrates that training gained using standard ultrasound machines can be easily and successfully adapted to newer handheld ultrasound devices. The examination technique using the handheld device is illustrated with photos and a video.

scholarly journals Altered DNA methylation pattern reveals epigenetic regulation of Hox genes in thoracic aortic dissection and serves as a biomarker in disease diagnosis

2021 ◽  
Vol 13 (1) ◽  
Author(s):  
Peiru Liu ◽  
Jing Zhang ◽  
Duo Du ◽  
Dandan Zhang ◽  
Zelin Jin ◽  
...  
Keyword(s):  
Dna Methylation ◽  
Aortic Dissection ◽  
Epigenetic Regulation ◽  
Heart Development ◽  
Type A ◽  
Methylation Pattern ◽  
Healthy Controls ◽  
Global Methylation ◽  
Thoracic Aortic Dissection

Abstract Background Thoracic aortic dissection (TAD) is a severe disease with limited understandings in its pathogenesis. Altered DNA methylation has been revealed to be involved in many diseases etiology. Few studies have examined the role of DNA methylation in the development of TAD. This study explored alterations of the DNA methylation landscape in TAD and examined the potential role of cell-free DNA (cfDNA) methylation as a biomarker in TAD diagnosis. Results Ascending aortic tissues from TAD patients (Stanford type A; n = 6) and healthy controls (n = 6) were first examined via whole-genome bisulfite sequencing (WGBS). While no obvious global methylation shift was observed, numerous differentially methylated regions (DMRs) were identified, with associated genes enriched in the areas of vasculature and heart development. We further confirmed the methylation and expression changes in homeobox (Hox) clusters with 10 independent samples using bisulfite pyrosequencing and quantitative real-time PCR (qPCR). Among these, HOXA5, HOXB6 and HOXC6 were significantly down-regulated in TAD samples relative to controls. To evaluate cfDNA methylation pattern as a biomarker in TAD diagnosis, cfDNA from TAD patients (Stanford type A; n = 7) and healthy controls (n = 4) were examined by WGBS. A prediction model was built using DMRs identified previously from aortic tissues on methylation data from cfDNA. Both high sensitivity (86%) and specificity (75%) were achieved in patient classification (AUC = 0.96). Conclusions These findings showed an altered epigenetic regulation in TAD patients. This altered epigenetic regulation and subsequent altered expression of genes associated with vasculature and heart development, such as Hox family genes, may contribute to the loss of aortic integrity and TAD pathogenesis. Additionally, the cfDNA methylation in TAD was highly disease specific, which can be used as a non-invasive biomarker for disease prediction.

Clinical relevance of bilateral pleural effusion in patients with acute pulmonary embolism

2020 ◽  
Vol 50 (8) ◽  
pp. 938-944
Author(s):  
Ofer Levy ◽  
Daniel Fux ◽  
Tetiana Bartsikhovsky ◽  
Sergei Vosko ◽  
Moshe Tishler ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Pleural Effusion ◽  
Clinical Relevance ◽  
Acute Pulmonary Embolism ◽  
Bilateral Pleural Effusion

scholarly journals Acute pulmonary embolism following acute type A aortic dissection in a patient with COVID‐19

2021 ◽  
Author(s):  
David Volvovitch ◽  
Eilon Ram ◽  
Hillit Cohen ◽  
Alexander Kogan ◽  
Leonid Sternik ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Aortic Dissection ◽  
Acute Pulmonary Embolism ◽  
Type A ◽  
Acute Type ◽  
Type A Aortic Dissection
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