Look past the bleed! A case of non-traumatic thoracic aortic pseudoaneurysm presenting as haemoptysis
  • Fawwad Ansari
    Department of Internal Medicine, Piedmont Athens Regional Medical Center, Athens, USA
  • Bilal Hamid
    Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan
  • Fahad Mushtaq
    Department of Internal Medicine, Shifa International Hospital, Islamabad, Pakistan
  • Mubashira Aftab
    Department of Internal Medicine, Fazaia Medical College, Islamabad, Pakistan
  • Zainab Kiyani
    Department of Internal Medicine, Islamabad Medical and Dental College, Islamabad, Pakistan
  • Benjamin Lloyd
    Department of Internal Medicine, Reading Hospital, West Reading, USA
  • Muhammad Umer Riaz Gondal
    Department of Internal Medicine, Reading Hospital, West Reading, USA

Keywords

Haemoptysis, pseudoaneurysm, aorta, atherosclerosis, cardiovascular surgery

Abstract

Introduction: Aortic pseudoaneurysms are a type of contained rupture where most of the aortic wall is breached, leaving only a thin rim of the remaining wall or adventitia to hold the blood. This condition carries a high risk of rupture and potentially fatal complications. Typically, patients present with chest pain; haemoptysis can also occur, though rarely.
Case description: A 64-year-old male who presented with two episodes of haemoptysis, with no history of cardiovascular surgery or trauma. A chest computerized tomography (CT) followed by an aortogram revealed a thoracic aortic pseudoaneurysm and the patient underwent surgical aortic repair without any complications. This case underscores the rare presentation of thoracic aortic pseudoaneurysm.
Discussion: Haemoptysis is a rare manifestation of thoracic aorta pseudoaneurysm and can be a warning sign of impending rupture. Haemoptysis may occur due to formation of aortopulmonary fistula or direct erosion of pseudoaneurysm into lung parenchyma.
Conclusion: It is imperative for clinicians to recognise such manifestations early for prompt diagnosis and prevention of complications.

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References

  • Rivera PA, Dattilo JB. Pseudoaneurysm. [Updated 2024 Feb 17]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-.
  • Ali R, Elhosiny A, Abualnaja S, Baslaim G. Incidental finding of an aspergillus pseudoaneurysm in the ascending aorta of an immunocompetent patient. Int Med Case Rep J 2021;14:843–847.
  • Stamou SC, Conway BD, Nores MA. Management of aortic pseudoaneurysms: evolving concepts and controversies. Aorta (Stamford) 2020;8:1–5.
  • Natour M, Endovascular treatment of ascending and thoracic aortic arch pseudoaneurysm. J Vasc Surg 2019;70:e155. Available at: https://www.jvascsurg.org/article/S0741-5214(19)32037-3/pdf
  • Rodríguez-Hidalgo LA, Concepción-Urteaga LA, Hilario-Vargas JS, Ruiz-Caballero DC. Hemoptysis as a warning sign of thoracic aorta pseudoaneurysm: a case report. Medwave 2021;21:e8112. Spanish, English.

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    Published: 2024-07-04
    Issue: 2024: LATEST ONLINE (view)

    How to cite:
    1.
    Ansari F, Hamid B, Mushtaq F, Aftab M, Kiyani Z, Lloyd B, Gondal MUR. Look past the bleed! A case of non-traumatic thoracic aortic pseudoaneurysm presenting as haemoptysis. EJCRIM 2024;11 doi:10.12890/2024_004666.

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