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
Modality: X-ray

Ascending aorta appears dilated (allowing for AP projection)

Modality: CT

No pulmonary embolus.

Arch of aorta dilated with suggestion of intramural hematoma.

Pericardial effusion or hemopericardium.

Small right pleural effusion

Modality: 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: Chest, Vascular
Inclusion in quiz mode: Included

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