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A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination

CASE: Sometimes it is difficult to diagnose circumferential aortic dissection with enhanced computed tomography alone. A 58‐year‐old woman presented with sudden‐onset chest discomfort and loss of consciousness. Transthoracic echocardiogram showed mild aortic regurgitation. Enhanced computed tomograp...

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Autores principales: Yamagishi, Toshinobu, Kashiura, Masahiro, Nakata, Kazuya, Miyazaki, Kazuki, Yukawa, Takahiro, Tanabe, Takahiro, Sugiyama, Kazuhiro, Akashi, Akiko, Hamabe, Yuichi
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674476/
https://www.ncbi.nlm.nih.gov/pubmed/29123882
http://dx.doi.org/10.1002/ams2.262
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author Yamagishi, Toshinobu
Kashiura, Masahiro
Nakata, Kazuya
Miyazaki, Kazuki
Yukawa, Takahiro
Tanabe, Takahiro
Sugiyama, Kazuhiro
Akashi, Akiko
Hamabe, Yuichi
author_facet Yamagishi, Toshinobu
Kashiura, Masahiro
Nakata, Kazuya
Miyazaki, Kazuki
Yukawa, Takahiro
Tanabe, Takahiro
Sugiyama, Kazuhiro
Akashi, Akiko
Hamabe, Yuichi
author_sort Yamagishi, Toshinobu
collection PubMed
description CASE: Sometimes it is difficult to diagnose circumferential aortic dissection with enhanced computed tomography alone. A 58‐year‐old woman presented with sudden‐onset chest discomfort and loss of consciousness. Transthoracic echocardiogram showed mild aortic regurgitation. Enhanced computed tomography scans showed no obvious intimal tear or flap at the proximal ascending aorta, but an intimal flap was observed from the aortic arch to both common iliac arteries. Stanford type B dissection was tentatively diagnosed. Repeat detailed transthoracic echocardiography examination showed an intimal tear and flap at the ascending aorta; prolapse into the left ventricle caused severe aortic regurgitation. Type A aortic dissection was definitively diagnosed; emergent operation showed a circumferential intimal tear originating from the ascending aorta. OUTCOME: The ascending aorta was replaced; aortic regurgitation disappeared. The patient was discharged in a good condition 58 days postoperatively. CONCLUSION: Dynamic evaluations with transthoracic echocardiography should be carried out to diagnose circumferential aortic dissection.
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spelling pubmed-56744762017-11-09 A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination Yamagishi, Toshinobu Kashiura, Masahiro Nakata, Kazuya Miyazaki, Kazuki Yukawa, Takahiro Tanabe, Takahiro Sugiyama, Kazuhiro Akashi, Akiko Hamabe, Yuichi Acute Med Surg Case Reports CASE: Sometimes it is difficult to diagnose circumferential aortic dissection with enhanced computed tomography alone. A 58‐year‐old woman presented with sudden‐onset chest discomfort and loss of consciousness. Transthoracic echocardiogram showed mild aortic regurgitation. Enhanced computed tomography scans showed no obvious intimal tear or flap at the proximal ascending aorta, but an intimal flap was observed from the aortic arch to both common iliac arteries. Stanford type B dissection was tentatively diagnosed. Repeat detailed transthoracic echocardiography examination showed an intimal tear and flap at the ascending aorta; prolapse into the left ventricle caused severe aortic regurgitation. Type A aortic dissection was definitively diagnosed; emergent operation showed a circumferential intimal tear originating from the ascending aorta. OUTCOME: The ascending aorta was replaced; aortic regurgitation disappeared. The patient was discharged in a good condition 58 days postoperatively. CONCLUSION: Dynamic evaluations with transthoracic echocardiography should be carried out to diagnose circumferential aortic dissection. John Wiley and Sons Inc. 2017-03-02 /pmc/articles/PMC5674476/ /pubmed/29123882 http://dx.doi.org/10.1002/ams2.262 Text en © 2017 The Authors. Acute Medicine & Surgery published by John Wiley & Sons Australia, Ltd on behalf of Japanese Association for Acute Medicine. This is an open access article under the terms of the Creative Commons Attribution‐NonCommercial‐NoDerivs (http://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Case Reports
Yamagishi, Toshinobu
Kashiura, Masahiro
Nakata, Kazuya
Miyazaki, Kazuki
Yukawa, Takahiro
Tanabe, Takahiro
Sugiyama, Kazuhiro
Akashi, Akiko
Hamabe, Yuichi
A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination
title A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination
title_full A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination
title_fullStr A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination
title_full_unstemmed A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination
title_short A case of circumferential type A aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination
title_sort case of circumferential type a aortic dissection with intimal intussusception diagnosed using repeat transthoracic echocardiography examination
topic Case Reports
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5674476/
https://www.ncbi.nlm.nih.gov/pubmed/29123882
http://dx.doi.org/10.1002/ams2.262
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