scholarly journals Frank's sign with acute aortic dissection

2021 ◽  
Author(s):  
Hironobu Nishiori ◽  
Yuichi Hirano ◽  
Masayoshi Otsu ◽  
Hiroyuki Watanabe
Keyword(s):  
Computed Tomography ◽  
Back Pain ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Young Patients ◽  
Type A ◽  
Aortic Disease ◽  
Atherosclerotic Disease ◽  
Smoking History

A 59-year-old man with a long smoking history presented with sudden back pain. Frank’s sign was noticed in his bilateral ears, and computed tomography revealed Stanford type A acute aortic dissection. If young patients have Frank’s sign, attention should be paid to atherosclerotic disease including aortic disease.

scholarly journals Head and Neck Pain in Patients Presenting with Acute Aortic Dissection

Aorta ◽  
2018 ◽  
Vol 06 (06) ◽  
pp. 130-138 ◽  
Author(s):  
Stephen Philip ◽  
Emil Missov ◽  
Dan Gilon ◽  
Stuart Hutchison ◽  
Ali Khoynezhad ◽  
...  
Keyword(s):  
Back Pain ◽  
Aortic Dissection ◽  
Neck Pain ◽  
Head And Neck ◽  
Acute Aortic Dissection ◽  
Intramural Hematoma ◽  
Type A ◽  
White Female ◽  
Comorbidity Burden ◽  
Overall Mortality

Background Head and neck pain is an atypical presentation of acute aortic dissection. Classic teaching associates this pain with proximal dissections, but this has not been extensively studied. Methods Patients enrolled in the International Registry of Acute Aortic Dissection from January 1996 to March 2015 were included in this study. We analyzed the demographics, presentation, treatment, and outcomes of Type A aortic dissection patients presenting with head and neck pain (n = 812, 25.8%) and compared it with those without these symptoms (n = 2,341, 74.2%). Results Patients with head and neck pain were more likely to be white, female, with a family history of aortic disease. Patients with head and neck pain had higher percentages of back pain (43.3% vs. 37.5%, p = 0.005) and chest pain (87.6% vs. 79.3%, p < 0.001). On imaging, a higher percentage of those with head and neck pain had arch vessel involvement (44.3% vs. 38%, p = 0.010) and intramural hematoma (11.7% vs. 8.1%, p = 0.003). Surgical management was more common in patients with head and neck pain (89.8% vs. 85.2%, p = 0.001). Regarding outcomes, patients with head and neck pain had significantly higher rates of stroke than those without head and neck pain (13% vs. 9.9%, p = 0.016); however, overall mortality was lower for those with head and neck pain (19.5% vs. 23%, p = 0.038). Those with head and neck pain only had higher overall mortality compared to those with head and neck pain with chest or back pain (34.6% vs. 19.9%, p = 0.013). A logistic regression of mortality revealed that preoperative hypotension and age > 65 years were significantly associated with increased mortality. Conclusion Presence of head and neck pain in Type A dissection is associated with more arch involvement, intramural hematoma, and stroke. When isolating those with head and neck pain only, there appear to be a higher rate of comorbidity burden and higher overall mortality.

scholarly journals Non-contrast computed tomography of type A acute aortic dissection in patients with out-of-hospital cardiopulmonary arrest: a case series

2019 ◽  
Vol 3 (4) ◽  
pp. 1-5 ◽  
Author(s):  
Shinsuke Takeuchi ◽  
Yoshihiro Yamaguchi ◽  
Hideaki Yoshino
Keyword(s):  
Computed Tomography ◽  
Aortic Dissection ◽  
Causes Of Death ◽  
Acute Aortic Dissection ◽  
Cardiopulmonary Arrest ◽  
Case Series ◽  
Type A ◽  
Autopsy Imaging ◽  
Conventional Autopsy ◽  
Contrast Ct

Abstract Background The prognosis of patients admitted for acute aortic dissection (AAD) has remarkably improved. However, we must also consider out-of-hospital cardiopulmonary arrest (OHCPA) patients while assessing the prognosis. In recent years, autopsy imaging has become more common as an alternative to conventional autopsy. Therefore, we reviewed our OHCPA patients with type A AAD using acute phase non-contrast computed tomography (CT). Case summary Here, we report a case series of three patients who developed OHCPA and were diagnosed with type A AAD using non-contrast CT. Although the direct causes of death varied in each case, we could easily determine the direct causes of death from clinical course of the condition and from non-contrast CT. Discussion Although non-contrast CT does not completely replace autopsy, if its convenience and non-invasiveness make it possible for more patients to undergo the procedure, the real prognosis (including morbidity and mortality) may be better understood. Therefore, we considered it significant to use non-contrast CT for investigating the cause of sudden death.

scholarly journals Anterograde Amnesia as a Manifestation of Acute Type A Aortic Dissection

2019 ◽  
Vol 29 (04) ◽  
pp. 263-266 ◽  
Author(s):  
Claudia Stöllberger ◽  
Julia Koller ◽  
Josef Finsterer ◽  
Dominic Schauer ◽  
Marek Ehrlich
Keyword(s):  
Computed Tomography ◽  
Chest Pain ◽  
Aortic Dissection ◽  
Memory Impairment ◽  
Acute Aortic Dissection ◽  
Anterograde Amnesia ◽  
Type A ◽  
Type A Aortic Dissection ◽  
D Dimer ◽  
Aortic Dissection Type A

Objectives Memory impairment has been only rarely reported in association with acute aortic dissection type A. We report a patient with pure anterograde amnesia and memory impairment of contents occurring after the event, accompanying acute aortic dissection type A. Case Report A previously healthy 53-year-old Caucasian male was admitted because of sudden chest pain after having lifted a heavy object. Clinical examination and electrocardiogram showed no abnormalities. Since blood tests showed leukocytosis, anemia, and elevated D-dimer level, either pulmonary embolism or aortic dissection was suspected; therefore, computed tomography was suggested. The patient seemed disoriented to time, and neurologic investigation confirmed that the patient was disoriented to time; short time memory was severely impaired and concentration was reduced. An amnestic episode with anterograde amnesia was diagnosed. Computed tomography showed type A aortic dissection. A supracoronary replacement of the ascending aorta was performed. The patient was discharged on the 7th postoperative day. Three months postoperatively, the patient is clinically stable; however, amnesia for the interval between pain onset and cardiac surgery persists. Conclusions Transient amnesia, usually considered a benign syndrome, may be more common than generally recognized in aortic dissection. The suspicion for aortic dissection or other cardiovascular emergencies is substantiated when amnesia is associated with sudden onset of chest pain, leukocytosis, and elevated D-dimer levels. Computed tomography of the aorta with contrast medium is the imaging method of choice to confirm or exclude the diagnosis.

scholarly journals Incidence, Risk Factors and Outcomes of Postoperative Headache After Stanford Type a Acute Aortic Dissection Surgery

2021 ◽  
Vol 8 ◽  
Author(s):  
Dashuai Wang ◽  
Sheng Le ◽  
Jingjing Luo ◽  
Xing Chen ◽  
Rui Li ◽  
...  
Keyword(s):  
Risk Factors ◽  
Clinical Practice ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Prediction Models ◽  
Multivariate Logistic Regression Analysis ◽  
Type A ◽  
Smoking History ◽  
Incidence Risk ◽  
Postoperative Headache

Background: Postoperative headache (POH) is common in clinical practice, however, no studies about POH after Stanford type A acute aortic dissection surgery (AADS) exist. This study aims to describe the incidence, risk factors and outcomes of POH after AADS, and to construct two prediction models.Methods: Adults who underwent AADS from 2016 to 2020 in four tertiary hospitals were enrolled. Training and validation sets were randomly assigned according to a 7:3 ratio. Risk factors were identified by univariate and multivariate logistic regression analysis. Nomograms were constructed and validated on the basis of independent predictors.Results: POH developed in 380 of the 1,476 included patients (25.7%). Poorer outcomes were observed in patients with POH. Eight independent predictors for POH after AADS were identified when both preoperative and intraoperative variables were analyzed, including younger age, female sex, smoking history, chronic headache history, cerebrovascular disease, use of deep hypothermic circulatory arrest, more blood transfusion, and longer cardiopulmonary bypass time. White blood cell and platelet count were also identified as significant predictors when intraoperative variables were excluded from the multivariate analysis. A full nomogram and a preoperative nomogram were constructed based on these independent predictors, both demonstrating good discrimination, calibration, clinical usefulness, and were well validated. Risk stratification was performed and three risk intervals were defined based on the full nomogram and clinical practice.Conclusions: POH was common after AADS, portending poorer outcomes. Two nomograms predicting POH were developed and validated, which may have clinical utility in risk evaluation, early prevention, and doctor-patient communication.

scholarly journals Successful treatment of atypical type A aortic dissection after heart transplantation

2021 ◽  
Author(s):  
Shenglei Shu ◽  
Lan Cheng ◽  
Jing Wang ◽  
Chuansheng Zheng
Keyword(s):  
Computed Tomography ◽  
Low Back Pain ◽  
Back Pain ◽  
Surgical Treatment ◽  
Aortic Dissection ◽  
Heart Transplantation ◽  
Type A ◽  
Low Back ◽  
Magnetic Resonance Examination ◽  
Type A Aortic Dissection

Abstract We report a case of a 58-year-old female with Stanford type A aortic dissection sparring the donor aorta 2 years after heart transplantation. Lumbar spine magnetic resonance examination for low back pain discovered the aortic dissection which was confirmed by following computed tomography angiography. The patient received surgical treatment including total arc replacement and thoracic aortic endovascular repair and recovered well.

scholarly journals Computed Tomography Imaging Artifact Simulating Type A Aortic Dissection

Aorta ◽  
2016 ◽  
Vol 04 (02) ◽  
pp. 72-73 ◽  
Author(s):  
Alan Chou ◽  
Bulat Ziganshin ◽  
John Elefteriades
Keyword(s):  
Computed Tomography ◽  
Aortic Dissection ◽  
Type A ◽  
Motion Artifact ◽  
Aortic Disease ◽  
Motion Artifacts ◽  
Type A Aortic Dissection ◽  
Contrast Enhanced ◽  
Imaging Artifact ◽  
Enhanced Computed Tomography

AbstractContrast-enhanced computed tomography (CT) is an effective tool for assessment of thoracic aortic disease in the modern era. Here, we describe a case of Type A aortic dissection incidentally detected by CT in a 63-year old man. Upon more precise imaging with electrocardiography (ECG)-gated CT, the dissection vanished, revealing it to be an aortic motion artifact. This report highlights the importance of motion artifacts mimicking a dissection flap. CT imaging gated with ECG can distinguish a dissection flap from an artifact.

scholarly journals Prediction of Intimal Tear Site by Computed Tomography in Acute Aortic Dissection Type A

2016 ◽  
Vol 46 (1) ◽  
pp. 48 ◽  
Author(s):  
Jun Sung Kim ◽  
Kay-Hyun Park ◽  
Cheong Lim ◽  
Dong Jin Kim ◽  
Yochun Jung ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Aortic Dissection ◽  
Acute Aortic Dissection ◽  
Type A ◽  
Aortic Dissection Type A ◽  
Intimal Tear
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