A Painless Thoracic Aortic Dissection

  • Youssef Mahmoud SHO General Internal Medicine, Ashford and St. Peters NHS Foundation Trust, Ashford
  • Tamer Shalaby ST7 Acute and General Internal Medicine HEKSS, Ashford and St. Peters NHS Foundation Trust, Ashford
  • Nazia Rashid Consultant Diabetes, Endocrinology and Acute Medicine, Ashford and St. Peters NHS Foundation Trust, Ashford

Keywords

Thoracic Aortic Dissection, CT Aortogram, D-dimer, EVAR

Abstract

Thoracic aortic dissection (TAD) has a very high mortality rate and is often missed due to the atypical presentation of patients. We present a case of a man with chronic hypertension, atrial fibrillation (AF) (on regular warfarin) and a previous endovascular aneurysm repair (EVAR), who presented with dyspepsia and was incidentally found to have a ruptured distal thoracic aneurysm on imaging with no obvious clinical signs on examination, nor abnormalities on admission chest x-ray (CXR).

VIEW THE ENTIRE ARTICLE

References

Meszaros I, Mórocz J, Szlávi J, Schmidt J, Tornóci L et al. Epidemiology and clinicopathology of aortic dissection. Chest 2000;117:1271–1278.

Bickerstaff LK, Pairolero PC, Hollier LH, Melton LJ, Van Peenen HJ et al. Thoracic aortic aneurysms: a population-based study. Surgery 1982;92:1103–1108.

Clouse WD, Hallett JW Jr, Schaff HV, Spittell PC, Rowland CM et al. Acute aortic dissection: population-based incidence compared with degenerative aortic aneurysm rupture. Mayo Clin Proc 2004;79:176–180.

Tsai TT, Nienaber CA, Eagle KA. Contemporary Reviews in Cardiovascular Medicine. Acute Aortic Syndromes. Circulation 2005;112:3802–3813.

Hagan PG, Nienaber CA, Isselbacher EM, Bruckman D, Karavite DJ et al. The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease. JAMA 2000;283:897–903.

Gerber O, Heyer GE, Vieux H. Painless dissections of the aorta presenting as acute neurologic syndromes. Stroke 1986;17:644–7.

Veyssier-Belot C, Cohen A, Rougemont D, Levy C, Amarenco P et al. Cerebral infarction due to painless thoracic aortic and common carotid artery dissections. Stroke 1993;24:2111–2113.

Nienaber CA, Eagle KA. Aortic Dissection: New Frontiers in Diagnosis and Management. Circulation 2003;108:628–635.

Shimony A, Fillon KB, Mottillo S, Dourian T et al. Meta-analysis of usefulness of d-dimer to diagnose acute aortic dissection. Am J Cardiol 2011;107:1227–34.

Sommer T, Feshke W, Holzknecht N, Smekal AV, Keller E et al. Aortic dissection: a comparative study of diagnosis with spiral CT, multiplanar transesophageal echocardiography, and MR imaging. Radiology 1996;199:347–452.

Ince H, Neinaber CA. Diagnosis and management of patients with aortic dissection. Heart 2007;93:266–270.

Strayer RJ, Shearer PL, Hermann LK. Screening, Evaluation, and Early Management of Acute Aortic Dissection in the ED. Curr Cardiol Rev 2012;8:152-7.

Published: 2016-09-28

Issue: Vol. 3 No. 6 (view)

Section: Articles

How to cite:
1.
Mahmoud Y, Shalaby T, Rashid N. A Painless Thoracic Aortic Dissection. EJCRIM 2016;3 doi:10.12890/2016_000443.

Similar Articles

You may also start an advanced similarity search for this article.

Most read articles by the same author(s)