Images in emergency medicine: giant ascending aortic aneurysm dissection with hemopericardium

doi:10.5847/wjem.j.issn.1920-8642.2012.03.014

Abstract

Abstract:

BACKGROUND: Acute chest pain represents a common presentation at emergency department. Aortic dissection in young patients, however, is fortunately rare.

METHODS: We report a case of giant ascending aortic aneurysm with Stanford type A aortic dissection in an otherwise well 22-year-old male patient. Operative aortic valve and root replacement was undertaken with favourable outcome.

RESULTS: Histopathologic examination of the resected aorta revealed acute on chronic inflammatory change with Langerhans type giant cells consistent with a diagnosis of giant cell aortitis.

CONCLUSION: While uncommon, emergencies of the aorta may present in young patients. Predisposing conditions are discussed.

Key words: Aorta, Aneurysm, Tamponade, Dissection

Cite this article

Boon Ong, Martyn Harvey, Grant Cave. Images in emergency medicine: giant ascending aortic aneurysm dissection with hemopericardium[J]. World Journal of Emergency Medicine, 2012, 3(3): 235-236.

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URL: http://wjem.com.cn/EN/10.5847/wjem.j.issn.1920-8642.2012.03.014

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Figures/Tables 4

Figure 1.

Supine chest radiograph showing enlarged cardiac silhouette.

Figure 1.

Figure 2.

Bedside subxyphoid echocardiography demonstrating pericardial effusion (arrows).

Figure 2.

Figure 3.

Coronal computed tomography (arterial phase) of left ventricular outflow tract demonstrating an aneurysm.

Figure 3.

Figure 4.

Axial computed tomography at the level of the carina with arrow demonstrating dissection flap.

Figure 4.

References 3

1	Niclauss L, Delay D, von Segesser L. Type A dissection in young patients. Interact Cardio Vasc Thorac Surg 2011; 12:194-198.
2	Bayegan K, Domanovtis H, Schillinger M, Ehrlich M, Sodeck G, Laggner A. Acute type A aortic dissection: the prognostic impact of preoperative cardiac tamponade. Eur J Cardiothorac Surg 2001; 20:1194-1198. doi: 10.1016/s1010-7940(01)01017-x pmid: 11717027
3	Tan M, Morshuis W, Dossche K, Kelder J, Waanders F, Schepens M. Long-term results after 27 years of surgical treatment of acute type a aortic dissection. Ann Thorac Surg 2005; 80:523-529. doi: 10.1016/j.athoracsur.2005.02.059 pmid: 16039197

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