scholarly journals Acute Aortic Dissection Presenting with a Headache: An Easily Missed Life-threatening Emergency

Cureus ◽  
2018 ◽  
Author(s):  
Johnny Chahine ◽  
Bicky Thapa ◽  
Rama D Gajulapalli ◽  
Amer Kadri
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Life Threatening

scholarly journals Master of the Masquerade: An Atypical Presentation of Acute Aortic Dissection

2020 ◽  
Vol 2020 ◽  
pp. 1-4
Author(s):  
Ramy Mando ◽  
Daniel Tim ◽  
Anthony DeCicco ◽  
Justin Trivax ◽  
Ivan Hanson
Keyword(s):  
Mortality Rate ◽  
Early Diagnosis ◽  
Aortic Dissection ◽  
High Mortality ◽  
Acute Aortic Dissection ◽  
Atypical Presentation ◽  
Aggressive Management ◽  
Life Threatening

Acute aortic dissection (AAD) is associated with unacceptably high mortality rate. As such, early diagnosis and aggressive management are essential in order to avoid life-threatening complications. Herein, we report an atypical presentation of AAD and clinical sequelae.

scholarly journals Hybrid Stepwise External Wrapping for Type A Acute Aortic Dissection with Cerebral Malperfusion

2020 ◽  
Author(s):  
Yoshihiro Suematsu ◽  
Satoshi Nishi ◽  
Daisuke Arima ◽  
Akihiro Yoshimoto
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Aortic Rupture ◽  
False Lumen ◽  
Type A ◽  
Good Physical Condition ◽  
Threatening Condition ◽  
Valve Insufficiency ◽  
Life Threatening ◽  
Cerebral Malperfusion

Abstract Background: Acute aortic dissection (AAD) is a life-threatening condition which can lead to coronary, brachiocephalic or branch vessel malperfusion, as well as aortic valve insufficiency, or aortic rupture. Mortality of surgical treatment in high-risk or elderly patients with Type A AAD (TAAAD) still remains high, and treatment for such patients remains controversial. We report a successful treatment of TAAAD with a communicating false lumen in a 60-year-old man with acute hemi-cerebral malperfusion. Case presentation: The ascending aorta was wrapped with stepwise external wrapping (SEW) procedure, and subsequent thoracic endovascular aortic repair (TEVAR) was successfully performed. The patient was discharged in good physical condition without any complications. Conclusions: Hybrid therapy with SEW and TEVAR with TAAAD associated with major cerebral malperfusion should be considered, especially in patients for whom open surgery is extremely risky.

scholarly journals Impella insertion for residual aortic dissection

2021 ◽  
Author(s):  
Hisashi Yoshida ◽  
YUKI ICHIHARA ◽  
Ryogo Hoki ◽  
Hiroshi Niinami
Keyword(s):  
Aortic Dissection ◽  
Cardiogenic Shock ◽  
Acute Aortic Dissection ◽  
Postoperative Management ◽  
Graft Replacement ◽  
True Lumen ◽  
Heart Pump ◽  
Life Threatening

Acute aortic dissection with coronary malperfusion is a life-threatening disease, resulting in demanding postoperative management. We report a successful insertion of percutaneous heart pump Impella through the intact true lumen in a patient with residual aortic dissection after the graft replacement and its recovery from the post-cardiotomy cardiogenic shock.

scholarly journals Percutaneous balloon fenestration and stenting for life-threatening ischemic complications in patients with acute aortic dissection

1999 ◽  
Vol 117 (6) ◽  
pp. 1118-1127 ◽  
Author(s):  
Suzanne M. Slonim ◽  
D.Craig Miller ◽  
R.Scott Mitchell ◽  
Charles P. Semba ◽  
Mahmood K. Razavi ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Percutaneous Balloon ◽  
Ischemic Complications ◽  
Life Threatening

scholarly journals LO006: Interarm blood pressure differential as a clinical marker for acute aortic dissection in the emergency department

CJEM ◽  
2016 ◽  
Vol 18 (S1) ◽  
pp. S32-S32
Author(s):  
S.W. Um ◽  
R. Ohle ◽  
J.J. Perry
Keyword(s):  
Back Pain ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Tertiary Care ◽  
Mean Difference ◽  
Healthy Population ◽  
Chi Square ◽  
Significant Difference ◽  
Life Threatening ◽  
Chi Square Analysis

Introduction: Acute Aortic Dissection (AAD) is life threatening, requiring early diagnosis. Although previous literature suggest interarm BP differential is an independent predictor of AAD, up to 20% of a healthy population can have a significant differential. Our objectives were to assess the rate of bilateral BP measurement in acute non-traumatic truncal pain patients, and the association of BP differential with non-traumatic AAD. Methods: This is a historical matched case control study: participants were adults >18 years old presenting to two tertiary care EDs with a triage diagnosis of truncal (i.e. chest, abdominal, flank, back) pain. Cases were selected based on an ED or in-hospital diagnosis of non-traumatic AAD confirmed by CT or Echo. Controls were from a single calendar year matched in a 1:1.5 ratio by sex and age within 5 years. ED and referral consult BP measurements were used. Exclusion criteria: clear diagnosis on basic investigation (i.e. UTI, pneumonia, pneumothorax, acute fracture) or pain >14 days/no pain. Sample size of 126 cases and 183 controls was calculated based on 20% exposure in controls (80% power and alpha of 5%), to detect an OR >2. P-values were calculated using chi square analysis. Results: A total of 294 (119 cases, 175 controls) patients were included (mean 66+/-14.5yrs, 59.5% male). Cases (199 potential: 119 included; 80 excluded). Controls (8239 potential: 305 reviewed; 175 included; 130 excluded). Bilateral BP was measured in 70.6% of cases (n=84, mean difference=15.5mmHg) versus 31.3% of controls (n=55, mean difference=10.9mmHg). Among included controls, most common diagnoses were: Unspecified Chest (36.0%) or Abdominal (9.7%) Pain, ACS (12.6%), Muscular Back Pain (5.1%), and Renal Colic (4.0%). BP differential >10mmHg was found in 58.8% of cases and 40.7% of controls (P=0.10). A BP differential >20mmHg was found in 31.3% of cases and 22.2% of controls (P=0.37). BP differential >20mmHg did not significantly increase the odds of AAD (OR 2.0 (95%CI 0.82-4.90), p<0.129). Conclusion: Interarm BP differential is not routinely measured in ED patients with acute non-traumatic truncal pain, and there is no significant difference in the presence or magnitude of differentials in patients with or without AAD. Therefore, physicians should not rely on BP differentials to aid in their diagnosis or exclusion of AAD.

Association of Fiber Orientation and Dissection Properties of Ascending Thoracic Aortic Aneurysms With Aortic Valve Morphology

2011 ◽  
Author(s):  
Salvatore Pasta ◽  
Julie A. Phillippi ◽  
Antonio D’Amore ◽  
Michael S. Sacks ◽  
Simon C. Watkins ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Surgical Techniques ◽  
Aortic Aneurysms ◽  
Type A Aortic Dissection ◽  
Thoracic Aortic Aneurysms ◽  
International Registry ◽  
Life Threatening ◽  
Morbidity Risk ◽  
Emergent Surgery

Type A aortic dissection (AoD) of an ascending thoracic aortic aneurysm (ATAA) is a life-threatening cardiovascular emergency with a high potential for death. Despite improved surgical techniques, the morbidity risk for emergent surgery remains 24% worldwide according to data from the International Registry of Acute Aortic Dissection [1].

scholarly journals An Incident of a Massive Pulmonary Embolism following Acute Aortic Dissection. A Case Report

2021 ◽  
Vol 7 (1) ◽  
pp. 67-72
Author(s):  
Sofia Fernandes ◽  
Mariana Rodrigues ◽  
Catarina Barreiros ◽  
Hugo Côrte-Real ◽  
Ricardo Ferreira ◽  
...  
Keyword(s):  
Pulmonary Embolism ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Tertiary Hospital ◽  
Massive Pulmonary Embolism ◽  
Postoperative Recovery ◽  
Type A Aortic Dissection ◽  
Vein Thrombosis ◽  
Life Threatening ◽  
Deep Vein

Abstract Acute aortic dissection and acute pulmonary embolism are two life-threatening emergencies. The presented case is of an 81-year-old man who has been diagnosed with an acute Stanford type A aortic dissection and referred to a tertiary hospital for surgical treatment. After a successful aortic repair and an overall favourable postoperative recovery, he was diagnosed with cervical and upper extremity deep vein thrombosis and was anticoagulated accordingly. He later presented with massive bilateral pulmonary embolism.

scholarly journals Systems Biology Approaches-based Biomarkers Discovery for Acute Aortic Dissection

2018 ◽  
Vol 21 (5) ◽  
pp. E365-E369
Author(s):  
Qiang Huang ◽  
Yongqiang Ren ◽  
Hui Li ◽  
Youjin Qiao ◽  
Mingshan Lin
Keyword(s):  
Systems Biology ◽  
Aortic Dissection ◽  
High Throughput Screening ◽  
Acute Aortic Dissection ◽  
Cell Level ◽  
Diagnostic Biomarkers ◽  
Recent Developments ◽  
Life Threatening ◽  
Molecular Pathophysiology ◽  
Molecular Nature

Acute aortic dissection (AAD) faces great challenges in early diagnosis and effective drug treatment. Recent developments in systems biology approaches allow high-throughput screening of novel diagnostic biomarkers and potential therapeutic targets. In this review, we summarize the currently available AAD biomarkers identified in the context of genomic, transcriptomic, proteomic, and metabolic profiles, and highlight the benefits of using a combination of these findings for a better understanding of the molecular nature of this life-threatening disease. This review also provides a reference for future studies that employ a comprehensive, multiple-level approach at the single-cell level to decipher the underlying molecular pathophysiology of AAD.

scholarly journals Natural courses and long-term results of type A acute aortic intramural haematoma and retrograde thrombosed type A acute aortic dissection: a single-centre experience

2019 ◽  
Vol 30 (1) ◽  
pp. 113-120 ◽  
Author(s):  
Yen-Yu Chen ◽  
Hsu-Ting Yen ◽  
Chien-Ming Lo ◽  
Chia-Chen Wu ◽  
David Kwan-Ru Huang ◽  
...  
Keyword(s):  
Aortic Dissection ◽  
Medical Therapy ◽  
Acute Aortic Dissection ◽  
Survival Rates ◽  
Type A ◽  
Long Term Results ◽  
Urgent Surgery ◽  
Life Threatening ◽  
Thrombosed Type

Abstract OBJECTIVES Few reports on the outcomes of patients treated for Stanford type A acute aortic intramural haematoma (TAAIMH) and retrograde thrombosed type A acute aortic dissection exist. This study aimed to evaluate their long-term results and predictors of adverse outcomes. METHODS We retrospectively analysed 40 patients with TAAIMH and retrograde thrombosed type A acute aortic dissection. All patients underwent urgent surgery on presentation of life-threatening complications. Before discharge, 18 patients underwent open aortic surgery, and 22 were treated with medical therapy alone. Clinical features of these patients and image appearances were reviewed, and the relationship with overall survival, aortic events, and aortic death was investigated. RESULTS The in-hospital mortality rate was 4.5% (1 patient) with medical therapy alone and 11.1% (2 patients) with surgical intervention. No patient with initial medical therapy required urgent surgery for life-threatening complications beyond 3 days of admission. The overall survival and aortic death-free survival rates at 1, 5 and 10 years were 85.0%, 72.5% and 59.8% and 90.0%, 81.6% and 77.1%, respectively. TAAIMH associated with penetrating aortic ulcer (PAU) was a risk factor of aortic events (P = 0.020) and significantly influenced aortic death-free survival (P = 0.003). CONCLUSIONS Urgent surgery for complicated TAAIMH and retrograde thrombosed type A acute aortic dissection patients and initial medical therapy for uncomplicated patients show favourable long-term survival rates. TAAIMH is frequently associated with PAU; PAU enlargement is common. Although PAU can remain stable for years, it is a strong predictor of poor prognosis. For optimal long-term results, surgical repair is recommended for TAAIMH associated with PAU.

Sign in / Sign up

Export Citation Format

Share Document