11/244. Fatal hemoptysis in dissecting aortic aneurysm and salmonellosis: a case report.hemoptysis is a rare manifestation of dissecting aortic aneurysm and aortobronchial fistula may occur when an aortic aneurysm is mycotic, atherosclerotic, traumatic or postoperative. Aortobronchial fistulas are generally fatal if not treated surgically. An aggressive diagnostic approach to patients with hemoptysis and prompt surgical intervention in those suspected of aortobronchial fistulas should result in additional survivors. Imaging studies, including chest radiography, chest computerized tomography, arteriography and bronchoscopy provide useful diagnostic information. However, challenges remain when we encounter this condition. Sometimes, the final exsanguinating hemorrhage is preceded by a distinct prodromal period of intermittent hemoptysis. This allows clinicians time to recognize such fistulas and perform emergency surgery. We present a patient with this condition to alert clinicians to this potentially deadly cause of hemoptysis.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
12/244. Atypical presentation of dissection of the ascending aorta in young men with cystic medial necrosis: MR findings.dissection of the ascending aorta is usually associated with severe chest and/or back pain. We describe three young men, with pathologically proven cystic medial necrosis, who presented with atypical clinical symptoms and ascending aortic dissection diagnosed by MR imaging and surgery. patients with cystic medial necrosis and aortic dissection may not present with a classic acute chest pain syndrome.- - - - - - - - - - ranking = 8.5372075052508keywords = chest pain, chest (Clic here for more details about this article) |
13/244. Unusual presentation of dissecting aortic aneurysm.Dissecting aneurysms generally cause radiating back pain, chest pain, or symptoms caused by aortic insufficiency. Presentation solely with abdominal pain is rare. We report on a patient with dissecting thoracic aortic aneurysm who presented solely with abdominal pain. The possibility of intrathoracic disease must be considered in every patient with abdominal pain, especially if the pain is in the upper part of the abdomen.- - - - - - - - - - ranking = 8.0372075052508keywords = chest pain, chest (Clic here for more details about this article) |
14/244. Stanford type A acute dissection developing acute myocardial infarction.A 75-year-old female, exhibiting epigastric pain and vomiting, underwent treatment for acute gastritis. She also experienced incontinence of urine and chest pain. A diagnosis of acute myocardial infarction was made upon examination of electrocardiographic findings and the patient was transferred to our hospital. Diffuse infarction of the left ventricle and acute aortic dissection (Stanford type A) were diagnosed by electrocardiographic and echo-cardiography. An emergency operation was performed. After induction of anesthesia, elevation of pulmonary artery pressure and fall of pulse pressure were observed, indicating acute cardiac tamponade. Transesophageal ultrasonography disclosed the entry of dissection in the descending aorta. dissection of the aorta extended proximally up to the annulus of the aortic valve and the right and left coronary arteries were compressed by its aneurysm. As aortic insufficiency was mild, only reconstruction of the ascending aorta was carried out. The patient was discharged in fair condition one month after operation under use of postoperative long-term administration of catecholamines.- - - - - - - - - - ranking = 8.0372075052508keywords = chest pain, chest (Clic here for more details about this article) |
15/244. A case of aortic dissection with transient ST-segment elevation due to functional left main coronary artery obstruction.A 48-year-old man with a history of hypertension and diabetes mellitus was hospitalized with sudden onset of severe chest pain. He was in cardiogenic shock with a systolic pressure of 60 mm Hg. His electrocardiogram (ECG) showed ST-segment elevation in the precordial leads suggestive of acute anteroseptal myocardial infarction. The ST-segment returned to baseline after the systolic blood pressure rose to 100 mm Hg with the administration of sympathomimetic agents. aortography and transesophageal echocardiography demonstrated type A aortic dissection and aortic regurgitation. aortography and short-axis transesophageal echocardiography showed during diastole almost complete collapse of the true lumen of the ascending aorta caused by the intimal flap. The patient underwent surgical repair of the aortic dissection and implantation of Palmaz stents in the carotid arteries. Decreased blood pressure and the presence of aortic regurgitation accelerated the collapse of the true lumen during diastole in the ascending aorta, resulting in functional obstruction of the left main coronary artery, which may have been related to ST-segment changes in this case.- - - - - - - - - - ranking = 8.0372075052508keywords = chest pain, chest (Clic here for more details about this article) |
16/244. coronary artery bypass grafting for spontaneous coronary artery dissection: a case report and a review of the literature.A 37 year-old woman underwent coronary angiography because of chest pain at rest. Selective coronary angiography demonstrated dissection and stenosis with a filling delay from the left main trunk to the left anterior descending coronary artery. The patient was successfully managed with urgent coronary artery bypass grafting. Spontaneous coronary artery dissection is relatively rare and threatens both elderly and young patients with acute coronary disturbances. patients can be divided etiologically into three groups. The first was comprised of those in the postpartum period. The second was those with atherosclerotic coronary artery disease, and the third was those associated with coronary vasospasm. Dissections are frequently fatal and most of the known cases have been diagnosed at autopsy. Only a few cases have been documented by coronary angiography, and operative cases of spontaneous coronary artery dissection have rarely been reported.- - - - - - - - - - ranking = 8.0372075052508keywords = chest pain, chest (Clic here for more details about this article) |
17/244. Primary aortoesophageal fistula: presenting as massive upper gastrointestinal hemorrhage.Primary aortoesophageal fistula is a rare cause of upper gastrointestinal bleeding. A six-year-old boy presented with massive upper gastrointestinal hemorrhage. endoscopy revealed a submucosal bulge in the esophagus with an ulcer and clot at the top. Lateral skiagram of the chest showed a posterior mediastinal mass. CT scan of the chest revealed a ruptured aortic aneurysm into the oesophagus, confirmed the diagnosis. The patient succumbed to the illness before he could be subjected to definitive treatment.- - - - - - - - - - ranking = 1keywords = chest (Clic here for more details about this article) |
18/244. Global myocardial ischemia as a complication of an acute type A aortic dissection--rapid diagnosis of a case by transesophageal echocardiography.A 36-year-old female was admitted for severe chest pain followed by profound shock. electrocardiography showed severe ST segment depression (0.5-0.7 mV) in all leads except aVR and aVL. echocardiography revealed an intimal flap in the ascending aorta and coexisting grade 3 aortic regurgitation. She was immediately intubated and transferred to the intensive care unit. Transesophageal echocardiography (TEE) demonstrated an intimal tear at 2 cm above the sinotubular junction, and the ostium of the left main trunk was oppressed by the intimal flap during diastole. Emergency graft replacement of the ascending aorta and aortic hemiarch concomitant with aortic valve resuspension was performed successfully. The ECG changes reversed to normal immediately after the operation. The patient was extubated 2 days postoperatively and discharged from the hospital 14 days postoperatively. TEE is useful for the rapid evaluation of coronary malperfusion as a complication of acute aortic dissection, especially in patients with hemodynamic instability.- - - - - - - - - - ranking = 8.0372075052508keywords = chest pain, chest (Clic here for more details about this article) |
19/244. Aortic dissection with fistula to right atrium after heart transplantation: diagnosis by transthoracic and transesophageal echocardiography.Aortic dissection with rupture into the right atrium is an extremely rare and rapidly fatal condition that may occur after cardiac surgery. We report the case of a 59-year-old woman with a 6-year history of heart transplantation who presented with subacute illness characterized by chest pain and severe cardiac decompensation accompanied by a continuous murmur in the precordium. The diagnosis of aortic dissection complicated by right atrial fistula was made by the combination of transthoracic and transesophageal echocardiographic examination.- - - - - - - - - - ranking = 8.0372075052508keywords = chest pain, chest (Clic here for more details about this article) |
20/244. Surgical treatment for acute type A aortic dissection in pregnancy: a case of aortic root replacement just after cesarean section.A 25-year-old woman with marfan syndrome in the 37th week of pregnancy was referred for acute chest pain and dyspnea. An emergency cesarean section was performed because of fetal distress. Intraoperative echocardiography at the end of the cesarean section showed dilatation of the aortic root and dissection of the ascending aorta. The patient underwent replacement of the aortic root and the ascending aorta on the following day because of uterine bleeding. The postoperative course was uneventful for the mother and her baby.- - - - - - - - - - ranking = 8.0372075052508keywords = chest pain, chest (Clic here for more details about this article) |
| <- Previous || Next -> |