THE IMPACT OF DIAGNOSTIC DISCREPANCIES IN AORTIC DISSECTION MANAGEMENT
Journal Title: International Journal of Medical Research & Health Sciences (IJMRHS) - Year 2016, Vol 5, Issue 1
Abstract
Aortic dissection is uncommon with high mortality rate if untreated. We report a challenging case of long segment aortic dissection in which the dissection type was very difficult to identify due to limitations of the available imaging studies. 66-year-old male presented to us with 3 days history of chest pain and difficulty breathing. He is known to be hypertensive. In the emergency room, patient has systolic blood pressure >190. Chest X-ray showed widening of mediastinum. CT angiography of chest and abdomen showed an acute dissection of the thoracic aorta extending from the mid ascending aorta to the infra-renal aorta suggestive of Stanford type A aortic dissection. Transthoracic and Trans-esophageal echocardiography revealed a partially calcified intimal flap in the distal portion of the arch and in the descending thoracic aorta suggestive of Stanford type B aortic dissection. Medical treatment started, and repeated CT angiography was obtained and it confirmed type B aortic dissection. One week after discharge, patient was readmitted with severe neck pain and difficulty breathing. CT chest without contrast showed grossly stable appearance of type A dissection consistent with the first CT angiography. Cardiothoracic surgery immediately reevaluated the situation and recommended surgical intervention.
Authors and Affiliations
Abdalla Hassan| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, E-mail: abdalla.hassan@advocatehealth.com, MD; Ahmad Zabad| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD; Mercy Candrasekaran| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD; Abdul S. Mohammed| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD; Shafaq Mahmoud| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD; Prajwal Boddu| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657
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- EP ID EP11576
- DOI 10.5958/2319-5886.2016.00023.0
- Views 268
- Downloads 10
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