scholarly journals Penetrating Atheromatous Ulcer As A Precursor Of Aortic Dissection: A Case Report

2020 ◽  
Author(s):  
Priya Shah ◽  
Erik Polan
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Ulcer Patient ◽  
Intramural Hematoma ◽  
Ascending Aorta ◽  
Penetrating Aortic Ulcer ◽  
Ct Angiogram ◽  
Acute Aortic Syndromes ◽  
Life Threatening

Abstract Background: Acute aortic syndromes include a range of life-threatening conditions with the most familiar entity being aortic dissection. However, variants of aortic dissection also include intimal tear without hematoma, aortic intramural hematoma, and lastly penetrating aortic ulcer (PAU), which will be the focus of this case report. Most PAUs are located in the descending thoracic aorta (85-95%), but they can also occur in the ascending aorta or arch as in the current case. Case Presentation: We report a case of a 77 year old male who presented with chief complaint of intermittent right-handed weakness associated with no numbness or mental status changes. Patient was admitted for stroke workup with unrevealing findings on CT (computed tomography) for acute abnormalities or any hemodynamically significant stenosis on carotid ultrasound. CT angiogram of head/neck revealed a penetrating aortic ulcer of the lateral aspect of the mid to distal ascending aorta. Patient was then transferred for further evaluation to a center of higher level care for further management. Conclusions: Patient was evaluated for surgical repair of penetrating ascending aortic ulcer. Patient underwent serial imaging throughout hospital course which showed grossly similar findings to prior examination and thus no surgical intervention was needed at that time. Patient was recommended to have follow up CT scan in one month to monitor progression of aortic ulcer, however patient lost to follow-up thereafter. Penetrating aortic ulcers are rarely located in the ascending aorta and are considered precursors of life-threatening aortic dissections.

scholarly journals Penetrating Atheromatous Ulcer as a Precursor of Aortic Dissection: A Case Report

2020 ◽  
Author(s):  
Priya Shah ◽  
Erik Polan
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Ulcer Patient ◽  
Intramural Hematoma ◽  
Ascending Aorta ◽  
Current Case ◽  
Penetrating Aortic Ulcer ◽  
Ct Angiogram ◽  
Acute Aortic Syndromes ◽  
Life Threatening

Abstract Background: Acute aortic syndromes include a range of life-threatening conditions with the most familiar entity being aortic dissection. However, variants of aortic dissection also include intimal tear without hematoma, aortic intramural hematoma, and lastly penetrating aortic ulcer (PAU), which will be the focus of this case report. Most PAUs are located in the descending thoracic aorta (85-95%), but they can also occur in the ascending aorta or arch as in the current case.Case Presentation: We report a case of a 77 year old male who presented with chief complaint of intermittent right-handed weakness associated with no numbness or mental status changes. Patient was admitted for stroke workup with unrevealing findings on CT (computed tomography) for acute abnormalities or any hemodynamically significant stenosis on carotid ultrasound. CT angiogram of head/neck revealed a penetrating aortic ulcer of the lateral aspect of the mid to distal ascending aorta. Patient was then transferred for further evaluation to a center of higher level care for further management.Conclusions: Patient was evaluated for surgical repair of penetrating ascending aortic ulcer. Patient underwent serial imaging throughout hospital course which showed grossly similar findings to prior examination and thus no surgical intervention was needed at that time. Patient was recommended to have follow up CT scan in one month to monitor progression of aortic ulcer. Penetrating aortic ulcers are rarely located in the ascending aorta and are considered precursors of life-threatening aortic dissections.

scholarly journals A life-threatening spontaneous ascending aortic rupture due to a small penetrating aortic ulcer

2021 ◽  
Vol 9 ◽  
pp. 2050313X2110377
Author(s):  
Yasuhito Nakamura ◽  
Kiyoshi Doi ◽  
Syojiro Yamaguchi ◽  
Etsuji Umeda ◽  
Osamu Sakai ◽  
...  
Keyword(s):  
Rare Case ◽  
Aortic Wall ◽  
Aortic Rupture ◽  
Ascending Aorta ◽  
Bleeding Site ◽  
Penetrating Aortic Ulcer ◽  
Postoperative Course ◽  
Life Threatening ◽  
Aortic Dissections

We reported a rare case of spontaneous frank rupture of a small (4 mm) penetrating aortic ulcer in the ascending aorta resulted in catastrophic bleeding. The ulcer only created a pinhole wound in the adventitia without saccular aneurysms, intramural hematomas, or aortic dissections. Notably, the wound could be directly closed because the aortic wall was intact only 5 mm away from the bleeding site. The postoperative course was uneventful, and the patient was discharged on the 11th postoperative day. After 8 months, follow-up computed tomography showed no abnormality of the aortic wall at the repair site.

scholarly journals Temporoparietal Headache as the Initial Presenting Symptom of a Massive Aortic Dissection

2015 ◽  
Vol 2015 ◽  
pp. 1-4
Author(s):  
Manan Parikh ◽  
Abhinav Agrawal ◽  
Braghadheeswar Thyagarajan ◽  
Sayee Sundar Alagusundaramoorthy ◽  
James Martin
Keyword(s):  
Aortic Dissection ◽  
Intramural Hematoma ◽  
Acute Onset ◽  
Ascending Aorta ◽  
Medical Emergency ◽  
Descending Aorta ◽  
Severe Chest Pain ◽  
Hemodynamic Compromise ◽  
Life Threatening ◽  
Prompt Diagnosis

Aortic dissection is a life-threatening medical emergency often presenting with severe chest pain and acute hemodynamic compromise. The presentation of aortic dissection can sometimes be different thus leading to a challenge in prompt diagnosis and treatment as demonstrated by the following presentation and discussion. We present a case of a 71-year-old male who presented to the emergency department with complaints of left sided temporoparietal headache and was eventually diagnosed with a thoracic aortic dissection involving the ascending aorta and descending aorta, with an intramural hematoma in the descending aorta. This case illustrates the importance of keeping in mind aortic dissection as a differential diagnosis in patients with acute onset headaches in which any intracranial source of headache is not found.

scholarly journals Case Report: Are We Witnessing an Increase of Chronic Ascending Aortic Dissection as a Collateral Effect to the COVID-19 Pandemic?

2021 ◽  
Vol 8 ◽  
Author(s):  
Arnaud Lyon ◽  
Ziyad Gunga ◽  
Lars Niclauss ◽  
Valentina Rancati ◽  
Piergiorgio Tozzi
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Ct Scan ◽  
Type A ◽  
Ascending Aorta ◽  
Acute Type ◽  
Type A Aortic Dissection ◽  
Delayed Treatment ◽  
Lower Limb Pain ◽  
Life Threatening

Background: The COVID-19 (coronavirus disease 2019) pandemic is reducing health care accessibility to non–life-threatening diseases, thus hiding their real incidence. Moreover, the incidence of potentially fatal conditions such as acute type A aortic dissection seems to have decreased since the pandemic began, whereas the number of cases of chronic ascending aortic dissections dramatically increased. We present two patients whose management has been affected by the exceptional sanitary situation we are dealing with.Case report: A 70-year-old man with chest pain and an aortic regurgitation murmur had his cardiac workup delayed (4 months) because of sanitary restrictions. He was then diagnosed with chronic type A aortic dissection and underwent urgent replacement of ascending aorta and aortic root. The delay in surgical treatment made the intervention technically challenging because the ascending aorta grew up to 80 mm inducing strong adhesions and chronic inflammation. The second case report concerns a 68-year-old woman with right lower-limb pain who was diagnosed with deep vein thrombosis. However, a CT scan to exclude a pulmonary embolism could not be realized until 5 months later because of sanitary restrictions. When she eventually got the CT scan, it fortuitously showed a chronic dissection of the ascending aorta. She underwent urgent surgery, and the intervention was challenging because of adhesions and severe inflammation.Conclusion: Delayed treatment due to sanitary restrictions related to COVID-19 pandemic is having a significant impact on the management of potentially life-threatening conditions including type A aortic dissection. We should remain careful to avoid COVID-19 also hitting patients who are not infected with the virus.

scholarly journals Perforation of the atrial wall and aortic sinus after closure of an atrial septal defect with an Atriasept occluder: a case report

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Zai-Qiang Zhang ◽  
Jia-Wang Ding
Keyword(s):  
Case Report ◽  
Atrial Septal Defect ◽  
Septal Defect ◽  
Emergency Operation ◽  
Atrial Wall ◽  
Aortic Sinus ◽  
Case Presentation ◽  
Lethal Complications ◽  
Life Threatening

Abstract Background While the perforation of the atrial wall and aortic sinus after closure of an atrial septal defect (ASD) is rare, it’s life-threatening, with rapid progress and high mortality. To the best of our knowledge, 21 similar cases have been reported since 1976. Case presentation We report a 16-year-old male whose atrial septal defect (ASD) was closed using a 12-mm Amplatzer septal occluder (ASO). Atrial wall and aortic sinus perforation occurred 3 months after transcatheter closure, and the patient was discharged after emergency operation. He was discharged on the 12th postoperative day in good overall condition. Conclusions With this case report, we want to illustrate that although percutaneous closure of ASD is regarded as a routine procedure, we should not forget the potentially lethal complications, especially cardiac erosion. Therefore, we should carefully evaluate the risk of erosion before surgery, and careful lifelong follow-up is needed.

scholarly journals Gastric intramural hematoma subsequent to thoracic aortic dissection: Case report and literature review

2018 ◽  
Vol 36 ◽  
pp. 5-9 ◽  
Author(s):  
Alana Costa Borges ◽  
Marcelo de Sousa Cury ◽  
Gilberto F. de Carvalho ◽  
Stella Maria Torres Furlani
Keyword(s):  
Case Report ◽  
Literature Review ◽  
Aortic Dissection ◽  
Intramural Hematoma ◽  
Thoracic Aortic Dissection

ASCENDING AORTIC ANEURYSM – A CASE REPORT

2020 ◽  
Vol 1 (3) ◽  
pp. 54-55
Author(s):  
Prathap Kumar. J.
Keyword(s):  
Abdominal Aortic Aneurysm ◽  
Case Report ◽  
Aortic Aneurysm ◽  
Ascending Aorta ◽  
Leg Pain ◽  
Ultrasound Screening ◽  
Ascending Aortic Aneurysm ◽  
Risk Of Mortality ◽  
Abdominal Aortic ◽  
Life Threatening

An aortic aneurysm is an abnormal dilation of the aorta to greater than 1.5 times its normal size. They usually cause no symptoms except when ruptured. Occasionally, there may be symptoms like abdominal, back, or leg pain. They are most commonly located in the abdominal aorta, but can also be located in the thoracic aorta, rarely in arch of aorta. Abdominal aortic aneurysm is more common in men, a disease that is often asymptomatic and has up to a 90% risk of mortality if the aneurysm ruptures. It can be easily diagnosed by an ultrasound screening, and if the aneurysm is > 5.5 cm, it can be surgically repaired to prevent a life-threatening rupture. Aneurysm of the ascending aorta is rare but can be easily diagnosed by echocardiogram.

Type B Aortic Dissection Complicated by Intimo-Intimal Intussusception and Extensive Intimal Denuding: Case Report with Long-term Follow-up

2020 ◽  
Vol 69 ◽  
pp. 451.e5-451.e10
Author(s):  
Mary Lin ◽  
Alison O. Flentje ◽  
Charles Drucker ◽  
Siamak Dahi ◽  
Aakash Shah ◽  
...  
Keyword(s):  
Case Report ◽  
Aortic Dissection ◽  
Type B ◽  
Type B Aortic Dissection ◽  
Long Term Follow Up ◽  
Intimal Intussusception

The EMDR DeTUR protocol for the treatment of self-injury in a patient with severe personality disorder: a case report

2019 ◽  
Vol 5 (1) ◽  
pp. 27-38
Author(s):  
Phyllis Annesley ◽  
Adedayo Alabi ◽  
Laura Longdon
Keyword(s):  
Case Report ◽  
Factitious Disorder ◽  
Content Type ◽  
Self Injury ◽  
Life Threatening ◽  
History Of ◽  
Mental Health Difficulties ◽  
Healthcare Interventions ◽  
Therapy Sessions

Purpose The purpose of this paper is to describe the Eye movement desensitisation and reprocessing (EMDR) treatment of an adult female patient detained within a high secure hospital with complex mental health difficulties, including complex trauma, factitious disorder, self-injury and a history of offending. The EMDR treatment addressed the patient’s urges to engage in severe and sometimes life-threatening self-injury, a primary motive of which was to access physical healthcare interventions within a general hospital. The paper describes the wide-ranging benefits of the treatment and incorporates feedback from the patient and clinicians within her multi-disciplinary team (MDT). Design/methodology/approach Four triggers for self-injury were processed during the therapy using the DeTUR Protocol (Popky, 2005, 2009) and the Constant Installation of Present Orientation and Safety (CIPOS, Knipe, 2009a) method. In total, 18 one hour therapy sessions were delivered plus three follow-up sessions to continue to offer support and complete the post-treatment evaluation. Findings The level of urge for each trigger was reduced to 0 which the patient defined as “no urge to self-injure”. Benefits went well beyond self-injury with reported positive impacts on mood, thinking, sleep, concentration, memory and experience of flashbacks. Practical implications This case report demonstrates that the EMDR DeTUR Protocol together with the CIPOS method can be extremely valuable in the treatment of patients who self-injure. Originality/value The case report offers an important contribution to an area that requires much further research.

Diseases of the aorta

2011 ◽  
Author(s):  
Arturo Evangelista ◽  
T. González-Alujas
Keyword(s):  
Aortic Dissection ◽  
Thoracic Aorta ◽  
Imaging Techniques ◽  
Cost Effective ◽  
Transoesophageal Echocardiography ◽  
Left Ventricular ◽  
Ascending Aorta ◽  
Emergency Setting ◽  
Aortic Diseases

Evaluation of the aorta is a routine part of the standard echocardiographic examination, because echocardiography plays an important role both in the diagnosis and follow-up of aortic diseases. In particular, echocardiography is useful for assessing aorta size, biophysical properties, and atherosclerotic involvement of the thoracic aorta.Transthoracic echocardiography (TTE) permits adequate assessment of several aortic segments, particularly the aortic root and proximal ascending aorta. Transoesophageal echocardiography (TOE) overcomes the limitations of TTE in thoracic aorta assessment, so TTE and TOE should be used in a complementary manner.Although TOE is the technique of choice in the diagnosis of aortic dissection, TTE may be used as the initial modality in the emergency setting. Intimal flap in proximal ascending aorta, pericardial effusion/tamponade, and left ventricular function can be easily visualized by TTE. However, a negative TTE does not rule out aortic dissection and other imaging techniques must be considered. TOE should define entry tear location, mechanisms of aortic regurgitation, and true lumen compression.In addition, echocardiography is essential in selecting and monitoring surgical and endovascular treatment and in detecting possible complications. Although other imaging techniques have a greater field of view, echocardiography is portable, rapid, accurate, and cost-effective in the diagnosis and follow-up of most aortic diseases.

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