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Aortic dissection on CTPA

Case contributed by Brendon Friesen
Diagnosis certain


Chest tightness and hypertension, pleuritic chest pain. Breathless on exertion. Troponin elevated. ?Pulmonary embolus.

Patient Data

Age: 30
Gender: Male

Ascending aorta appears dilated (allowing for AP projection)


No pulmonary embolus.

Arch of aorta dilated with suggestion of intramural hematoma.

Pericardial effusion or hemopericardium.

Small right pleural effusion


Dissection flap involving ascending aorta. Intramural hematoma evident on non-contrast imaging.


Type A aortic dissection.


Case Discussion

Type A aortic dissection, which was initially suspected on CTPA, and confirmed with subsequent non-contrast/CTA aorta protocol imaging.

Non-contrast imaging is important to assess intramural hematoma, which may be difficult to appreciate on CTA images.

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