Aortic dissection

Case contributed by Prashant Mudgal
Diagnosis certain


Patient presented with dyspnea, chest pain and palpitations. The patient is known to suffer from hypertension.

Patient Data

Age: 50 years
Gender: Female

There is dilatation of aortic root, ascending aorta, aortic arch and descending aorta.

An intimal flap is seen extending from the aortic root proximally to below the origin of the renal arteries distally dividing the aortic lumen into true and false lumens (Stanford Type A and type I DeBakey classification).

Right brachiocephalic, left common carotid, left subclavian, superior mesenteric, inferior mesenteric and bilateral renal arteries are seen arising from true lumen.

There is significant narrowing at the origin of celiac trunk of abdominal aorta. Atherosclerotic wall calcification is noted at origin of left renal artery.

Cardiomegaly with dilatation of all cardiac chambers is noted.

Case Discussion

An aortic dissection is one of the acute aortic syndromes and a type of arterial dissection. It occurs when blood enters the medial layer of the aortic wall through a tear or penetrating ulcer in the intima and tracks along the media, forming a second blood-filled channel within the wall. 

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