Acute aortic dissection - Stanford type A
Systemic arterial hypertension. In ED for acute thoracic pain. Blood pressure 90/60 at both upper arms, bradycardia. At physical examination, no pulsating abdominal masses. Thoracic and abdominal CT with requested.
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Computed tomography angiography of whole aorta was performed.
Intimal flap was identified from aortic valvolar plane to external iliac arteries, with true lumen and false lumen equally opacified by contrast medium in arterial phase.
Small hematoma surrounding thoracic ascending aorta was seen.
Epiaortic arteries wasn't involed; celiac trunk, superior mesentery artery originate from true lumen.
Right renal artery originates from true lumen and it is involved by intimal flap in its proximal tract, with normal renal perfusion.
Left renal artery originates from false lumen with left renal hypoperfusion.
Case of acute aortic dissection (Type A Stanford classification)
Aortic dissection is an emergency setting, commonly seen in ED.
Computed tomography is the diagnostic modality of choice for its wide availability, rapid execution and interpretation.
This patient was referred for urgent cardiothoracic surgery.
- McMahon MA, Squirrell CA. Multidetector CT of Aortic Dissection: A Pictorial Review. Radiographics. 2010 Mar;30(2):445-60. doi: 10.1148/rg.302095104.