THE IMPACT OF DIAGNOSTIC DISCREPANCIES IN AORTIC DISSECTION MANAGEMENT

Abstract

Aortic dissection is uncommon with high mortality rate if untreated. We report a challenging case of long segment aortic dissection in which the dissection type was very difficult to identify due to limitations of the available imaging studies. 66-year-old male presented to us with 3 days history of chest pain and difficulty breathing. He is known to be hypertensive. In the emergency room, patient has systolic blood pressure >190. Chest X-ray showed widening of mediastinum. CT angiography of chest and abdomen showed an acute dissection of the thoracic aorta extending from the mid ascending aorta to the infra-renal aorta suggestive of Stanford type A aortic dissection. Transthoracic and Trans-esophageal echocardiography revealed a partially calcified intimal flap in the distal portion of the arch and in the descending thoracic aorta suggestive of Stanford type B aortic dissection. Medical treatment started, and repeated CT angiography was obtained and it confirmed type B aortic dissection. One week after discharge, patient was readmitted with severe neck pain and difficulty breathing. CT chest without contrast showed grossly stable appearance of type A dissection consistent with the first CT angiography. Cardiothoracic surgery immediately reevaluated the situation and recommended surgical intervention.

Authors and Affiliations

Abdalla Hassan| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, E-mail: abdalla.hassan@advocatehealth.com, MD; Ahmad Zabad| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD; Mercy Candrasekaran| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD; Abdul S. Mohammed| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD; Shafaq Mahmoud| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD; Prajwal Boddu| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657, MD| Advocate Illinois Masonic Medical center, 836 W Wellington Ave, Chicago, IL 60657

Keywords

Related Articles

Post-traumatic growth, hope, and depression in elderly cancer patients

Post-traumatic growth (PTG), depression, and hope have not been adequately studied among elderly cancer patients living in Middle East countries. The aim of the study was to assess these constructs in elderly cancer pa...

Acute Chikungunya Fever Presenting as Migratory Polyarthritis

The tropical arthritogenic chikungunya virus has become an increasingly medical and economic burden in affected areas as it can result in long term disabilities. Thus, the current challenge for physicians in epidemic ar...

TO STUDY THE EFFECT OF THE BODY MASS INDEX AND WAIST HIP RATIO ON BLOOD PRESSURE IN PRE- AND POST-MENOPAUSAL WOMEN

Background: Menopause is the transient period of declined ovarian activity and decreased oestrogen level associated with increased chances of obesity and increased comorbidities like hypertension, hypercholestrelemia, i...

Studying Patient Safety Culture from the Viewpoint of Nurse in educational hospitals Ilam City

Introduction: Patient safety culture is the first necessary step to reduce medical errors and improve patient's condition. In this context, this article aims at studying the condition of patient safety culture in hospit...

The impact of cigarette smoking on lung function in smokers with differences in their nicotine dependency

Exposure to the multiple toxins in tobacco smoke causes disease. Nicotine in tobacco plays a minor role, however addiction is the proximate cause for these smoke related diseases. Nicotine dependency leads to addiction...

Download PDF file
  • EP ID EP11576
  • DOI 10.5958/2319-5886.2016.00023.0
  • Views 281
  • Downloads 10

How To Cite

Abdalla Hassan, MD; Ahmad Zabad, MD; Mercy Candrasekaran, MD; Abdul S. Mohammed, MD; Shafaq Mahmoud, MD; Prajwal Boddu, MD (2016). THE IMPACT OF DIAGNOSTIC DISCREPANCIES IN AORTIC DISSECTION MANAGEMENT. International Journal of Medical Research & Health Sciences (IJMRHS), 5(1), 107-109. https://www.europub.co.uk/articles/-A-11576