Aortic dissection on CTPA

Case contributed by Dr Brendon Friesen

Presentation

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

Patient Data

Age: 30
Gender: Male
X-ray

Ascending aorta appears dilated (allowing for AP projection)

CT

No pulmonary embolus.

Arch of aorta dilated with suggestion of intramural hematoma.

Pericardial effusion or hemopericardium.

Small right pleural effusion

CT

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

Haemopericardium.

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 haematoma, which may be difficult to appreciate on CTA images.

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Case information

rID: 32636
Case created: 7th Dec 2014
Last edited: 7th Oct 2015
Systems: Vascular, Chest
Inclusion in quiz mode: Included

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