1/300. Aortic dissection in young patients with chronic hypertension.We describe four patients aged 14 to 21 years who developed acute aortic dissection. In three of the four patients, the course was fatal, despite aggressive medical and surgical intervention. All four patients had sustained systemic hypertension related to chronic renal insufficiency. The patients had no other identifiable risk factors for aortic dissection, including congenital cardiovascular disease, advanced atherosclerosis, vasculitis, trauma, pregnancy, or family history of aortic dissection. Although aortic dissection is rare in individuals younger than 40 years of age, young patients with sustained systemic hypertension are at increased risk for this serious and often fatal condition. physicians must be aware of this rare complication of hypertension and consider aortic dissection in the differential diagnosis of unusual chest, abdominal, and back pain in hypertensive children, adolescents, and young adults.- - - - - - - - - - ranking = 1keywords = chest, pain (Clic here for more details about this article) |
2/300. cardiac tamponade and death from intrapericardial rupture [corrected] of sinus of valsalva aneurysm.A 35-year-old woman presented with dyspnea and chest pain. She had a large aneurysm of the non-coronary sinus of valsalva. Before her scheduled urgent surgery, the patient collapsed and died of cardiac tamponade secondary to intrapericardial rupture of the aneurysm. We would advocate urgent repair of this type of lesion to prevent such an outcome. We are aware of no other specific reports addressing extracardiac rupture of non-coronary cusp aneurysms [corrected].- - - - - - - - - - ranking = 15.068208732462keywords = chest pain, chest, pain (Clic here for more details about this article) |
3/300. Surgical treatment of traumatic aneurysm of the ascending aorta.Traumatic aneurysm of the ascending aorta is a rare event. This case describes a patient with such an aneurysm, resulting from injuries received in a motorcycle accident. The patient was admitted to the emergency room of a local hospital complaining of chest pain, and was subsequently referred to our institution. On admission, a chest x-ray showed mediastinal widening. Computed tomography and aortography revealed an ascending aortic aneurysm and contusion of the upper lobe of the right lung. Due to concerns about bleeding from the lung contusion, surgery was delayed for one week. During surgery, intimal tears were detected at two sites in the ascending aorta. The wall of the ascending aorta was subsequently resected and a prosthetic graft inserted. The postoperative period was uneventful and a postoperative aortogram showed that the graft had molded well.- - - - - - - - - - ranking = 15.90420097795keywords = chest pain, chest, pain (Clic here for more details about this article) |
4/300. Complete interruption of the aorta in Noonan's syndrome.A patient is presented who lived to age 60 with complete interruption of the aorta associated with Noonan's syndrome. On chest x-ray there were calcified mediastinal masses and bilateral rib notching. angiography demonstrated complete interruption of the aorta with markedly dilated tortuous intercostal arteries. The roentgenographic studies are correlated with the surgical and pathological findings. Noonan's syndrome is discussed.- - - - - - - - - - ranking = 0.83599224548833keywords = chest (Clic here for more details about this article) |
5/300. Takayasu's aortitis with dissection in systemic lupus erythematosus.A forty-seven-year-old Japanese woman under treatment for systemic lupus erythematosus (SLE), complained of severe back pain. Chest X-ray and MRI showed an aneurysmal dilatation of the ascending aorta. Subsequently an aortic replacement was performed. Microscopically, the resected aorta showed Takayasu's aortitis with chronic dissection. Both aortitis and dissection are rare events in SLE patients. To our knowledge, this is the first report of Takayasu's aortitis with dissection in a patient with SLE.- - - - - - - - - - ranking = 0.16400775451167keywords = pain (Clic here for more details about this article) |
6/300. Intimal-type primary sarcoma of the aorta. Report of a case with evidence of rhabdomyosarcomatous differentiation.We report an intimal sarcoma presenting as an aortic aneurysm. A 68-year-old man suffered from chest pain and speech disturbance. Computed tomography showed a sacciform aneurysm of the aorta, which was resected, revealing a polypoid tumour measuring 1.5x2x2.5 cm projecting into the lumen. This proved to be a poorly differentiated high-grade sarcoma having morphological, immunophenotypic and ultrastructural features consistent with rhabdomyosarcomatous differentiation. Primary sarcomas of the aorta are extremely rare. Many cases have been diagnosed as "intimal" on the basis of their site of origin, and they are not easy to classify from their histological pattern. Electron microscopy and the use of a more comprehensive panel of immunohistochemical markers should be applied in the histological classification of"intimal" sarcoma.- - - - - - - - - - ranking = 15.068208732462keywords = chest pain, chest, pain (Clic here for more details about this article) |
7/300. Painless aortic dissection presenting as hoarseness of voice: cardiovocal syndrome: Ortner's syndrome.Most of the neurological manifestations of the aortic dissection are due to neuronal ischemia secondary to either extension of the dissection process into a branch artery, or compression of an artery by the false lumen of the dissecting aortic hematoma. However, the enlarging false lumen may directly compress on an adjacent nerve, causing neuronal injury resulting in neurological symptoms. This may particularly take place when a distal intimal tear does not decompress the false lumen, resulting in formation of an expanding blind pouch. About 10% of aortic dissections are painless and may present with symptoms secondary to the complications of the dissection. Although cardiovocal syndrome, or Ortner's syndrome (hoarseness of voice due to involvement of recurrent laryngeal nerve in cardiovascular diseases) has been described with aortic dissection, it has not been reported as an initial presenting feature of this disorder. This report describes the first case of painless aortic dissection presenting with hoarseness of voice, the cardiovocal syndrome. The hoarseness remained the only symptom throughout the entire course of the disease. The aortic dissection was not suspected initially. During surgical exploration, the recurrent laryngeal nerve was found compressed by the false lumen at the level of aortic arch. Aortic root replacement was performed successfully, resulting in complete resolution of the hoarseness. The neurological manifestations of aortic dissection, and the cardiovocal syndrome, are discussed.- - - - - - - - - - ranking = 0.32801550902334keywords = pain (Clic here for more details about this article) |
8/300. An ascending aortic aneurysm caused by giant cell arteritis: report of a case.A 69-year-old woman was referred to our hospital for investigation of an abnormality detected by a chest roentgenogram, and was subsequently found to have an ascending aortic aneurysm. She had not suffered any symptoms such as headache or polymyalgia rheumatica. Aneurysmectomy and reconstruction of the ascending aorta was performed using cardiopulmonary bypass, and pathological examination of the aneurysmal wall revealed giant cell arteritis (GCA). Preoperatively, she had not suffered any temporal pain, and no signs of inflammation were detected serologically. GCA is a rare cause of aortic aneurysm in the Japanese population, and a brief review of the literature on this unusual entity is presented following this case report.- - - - - - - - - - ranking = 1keywords = chest, pain (Clic here for more details about this article) |
9/300. Aortic dissection: A "humerus" case.Aortic dissection usually presents with acute onset of severe chest pain. Classically there is a pressure differential between the 2 arms and widening of the mediastinum. echocardiography is considered the investigation of choice in many institutions. A case is presented in which the presentation and clinical signs are classical for dissection. Transthoracic echocardiography demonstrated "enlargement" of the descending aorta and a "flap." A surprise diagnosis was made by transesophageal echocardiography. Other vascular structures in the para-aortic regions should be considered when the diagnosis of aortic dissection is entertained.- - - - - - - - - - ranking = 15.068208732462keywords = chest pain, chest, pain (Clic here for more details about this article) |
10/300. Giant unruptured aneurysm of the thoracic aorta--a case report.An asymptomatic 88-year-old woman underwent a screening medical examination. The chest x-ray film showed a large mediastinal mass with calcification. Both chest computed tomography and nuclear magnetic resonance imaging revealed an unruptured aortic aneurysm, predominantly affecting the ascending aorta and the proximal part of the aortic arch. Its maximum diameter was 10.5 cm. An ascending aortic aneurysm more than 10 cm in diameter is very rare. She died of acute pulmonary embolism unrelated to the aneurysm, and autopsy indicated that the etiology of the aneurysm was atherosclerotic degeneration. Retrospectively, the natural progression of the aneurysm was able to be followed on a series of chest x-ray films obtained over 18 years.- - - - - - - - - - ranking = 2.507976736465keywords = chest (Clic here for more details about this article) |
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