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Inicio Archivos de Cardiología de México Image of an extensive aneurysm in a young patient
Información de la revista
Vol. 86. Núm. 4.
Páginas 374-375 (octubre - diciembre 2016)
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Vol. 86. Núm. 4.
Páginas 374-375 (octubre - diciembre 2016)
Image in cardiology
Open Access
Image of an extensive aneurysm in a young patient
Imagen de un aneurisma extenso en un paciente joven
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2554
Tatiana Chantal Castro-De la Torrea, Leticia Rodríguez-Mariscala, Martha A. Hernández-Gonzálezb, Sergio Solorioc,
Autor para correspondencia
soloriosergio@aol.com
sergio.solorio@imss.gob.mx

Corresponding author at: Unidad de Investigagción, UMAE 1 Del Bajío León IMSS, Blvd Lopez Mateos esq Insurgentes SN, León Gto, Mexico CP 37320, Mexico. Tel.: +52 477 7174800x31788.
a Servicio de Cardiología, UMAE 1 Bajío IMSS, León Gto, Mexico
b Servicio de Cardiología, HGZ 21 IMSS, León Gto, Mexico
c Unidad de Investigación, UMAE 1 Bajío IMSS, León Gto, Mexico
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The acute aortic syndrome refers to a spectrum of life-threatening aortic emergencies. Acute aortic syndromes include non-traumatic entities as aortic dissection with an incidence of 80–90% of the cases, affecting 5–30 person-years, penetrating atherosclerotic ulcer with a incidence of 2.8% and intramural hematoma with incidence of 5–25%. Nowadays there are several imaging modalities for diagnosis, such as echocardiography, magnetic resonance imaging and computed tomography angiogram without let out the clinical characteristics and keep in mind differential diagnosis for initial suspicion (Figs. 1 and 2).1–3

Figure 1.

Axis suprasternal echocardiogram, aortic arch and descending aorta is observed, with double-lumen image.

(0.11MB).
Figure 2.

(A and B) Chest CT sagittal and axial scans showing aneurysmal dilatation with extravasation area, left pleural effusion. (C–E) Sagittal and coronal section showing double lumen from descending aorta to common iliac. (F) Digital reconstruction of aorta.

(0.53MB).

We report the case of a hypertensive 42-year-old, with obesity and obstructive sleep apnea. He starts with oppressive chest pain with adrenergic discharge at rest, lasting 40min, blood pressure was documented to 180/111, electrocardiogram with positive slope of the ST in aVR and V1 and negative troponin. The patient developed cardiogenic shock and death.4–7 Acute aortic syndrome should be identified early by clinical suspicion and supported by diagnostic studies to provide timely treatment because of its high mortality rate. Diagnostic imaging studies in clinical suspicion of dissection play an important role, such as confirmation of clinical suspicion, classification of dissection, localization of tears, assessment of extent of dissection and indicators of urgency.8

Ethical responsibilitiesProtection of human and animal subjects

The authors declare that no experiments were performed on humans or animals for this study.

Confidentiality of data

The authors declare that no patient data appear in this article.

Right to privacy and informed consent

The authors declare that no patient data appear in this article.

Funding

No endorsement of any kind received to conduct this study/article.

Conflict of interest

The authors declare no conflict of interest.

References
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Acute aortic syndrome.
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Eur J Radiol, 65 (2008), pp. 350-358
[3]
P.G. Hagan, C.A. Nienaber, E.M. Isselbacher, et al.
The International Registry of Acute Aortic Dissection (IRAD): new insights into an old disease.
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Management of acute aortic syndromes.
Eur Heart J, 33 (2012), pp. 26-35
[5]
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Screening abdominal aorta aneurysm during echocardiography: literature review and proposal for a French nationwide study.
Arch Cardiovasc Dis, 103 (2010), pp. 552-558
[6]
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Interventional planning and assistance for ascending aorta dissections.
IRBM, 34 (2013), pp. 306-310
[7]
E. Bossone, R.E. Pyeritz, P. O’Gara, et al.
Acute aortic dissection in blacks: insights from the International Registry of Acute Aortic Dissection.
Am J Med, 126 (2013), pp. 909-915
[8]
C.A. Nienaber.
The role of imaging in acute aortic syndrome.
Eur Heart J Cardiovasc Imaging, 14 (2013), pp. 15-23
Copyright © 2016. Instituto Nacional de Cardiología Ignacio Chávez
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