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Related Concept Videos

Aneurysm III: Interprofessional Care01:26

Aneurysm III: Interprofessional Care

Aneurysm management involves either conservative medical therapy or surgical intervention, depending on the size and symptoms of the aneurysm. Conservative management is generally reserved for smaller, asymptomatic aneurysms, while larger or symptomatic aneurysms often necessitate surgical repair.Conservative Medical TherapyFor small, asymptomatic aneurysms, particularly abdominal aortic aneurysms (AAA) less than 5.5 centimeters in diameter, conservative medical therapy is recommended. This...
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Thoracic, aortic arch and abdominal aneurysms are significant vascular conditions that can present with various clinical manifestations and lead to serious complications. Understanding these manifestations and the appropriate diagnostic studies is essential for effective management and treatment.Thoracic Aortic AneurysmsThoracic aortic aneurysms often remain asymptomatic until they reach a size that impinges on adjacent structures. They typically cause deep, diffuse chest pain that radiates to...
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An aortic aneurysm is a localized outpouching or dilation at a weak point in the artery wall. It may involve different parts of the aorta, such as the abdominal aorta, aortic arch, or thoracic aorta.Etiological factorsSeveral disorders are associated with aortic aneurysms.Congenital causes, such as primary connective tissue disorders like Marfan syndrome, impact the integrity and strength of connective tissues, notably affecting the aorta. Marfan syndrome is a genetic disorder that specifically...
Hemorrhagic Stroke l: Introduction01:17

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A hemorrhagic stroke is an acute neurological event that occurs when a weakened cerebral blood vessel ruptures, allowing blood to accumulate within or around the brain. The sudden release of blood forms a focal hematoma that increases intracranial pressure, displaces neural tissue, and can obstruct cerebrospinal fluid pathways. These effects may be compounded by intraventricular extension of the hemorrhage, cerebral edema, or compression of adjacent structures, all of which contribute to...
Hemorrhagic Stroke ll: Pathophysiology01:29

Hemorrhagic Stroke ll: Pathophysiology

A hemorrhagic stroke develops when a cerebral blood vessel ruptures, allowing blood to escape into the surrounding brain tissue, as in intracerebral hemorrhage (ICH), or into the subarachnoid space, as in subarachnoid hemorrhage (SAH). Because the skull is a rigid compartment, the sudden presence of extravascular blood rapidly increases intracranial pressure and compresses adjacent neural structures, leading to immediate tissue injury and impaired cerebral perfusion.Mass Effect and Primary...
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An Approach to Point-Of-Care Ultrasound Evaluation of the Abdominal Aorta
07:12

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Published on: September 8, 2023

Intramural aortic hematoma: no flap no warning?

Rodolfo Citro1, Antonello Panza, Paolo Masiello

  • 1Department of Cardiology and Cardiac Surgery, University Hospital "Scuola Medica Salernitana", Salerno, Italy. rodolfocitro@teletu.it

Monaldi Archives for Chest Disease = Archivio Monaldi Per Le Malattie Del Torace
|July 15, 2011
PubMed
Summary

This case report details a 78-year-old female with type A intramural aortic hematoma (IMH). Advanced imaging confirmed the diagnosis, leading to urgent cardiac surgery for this acute aortic syndrome.

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Area of Science:

  • Cardiology
  • Vascular Surgery
  • Diagnostic Imaging

Background:

  • Intramural aortic hematoma (IMH) is a critical condition often presenting with symptoms mimicking other cardiovascular emergencies.
  • Prompt and accurate diagnosis is crucial for timely intervention in acute aortic syndromes (AAS).

Observation:

  • A 78-year-old female with hypertension presented with severe chest pain and signs of aortic insufficiency.
  • Initial investigations, including ECG and transthoracic echocardiography, ruled out myocardial ischemia but raised suspicion for AAS.
  • Computed tomography showed ascending aorta dilatation and wall thickening, but lacked a distinct intimal flap, complicating initial AAS assessment.

Findings:

  • Transesophageal echocardiography (TEE) definitively diagnosed type A intramural aortic hematoma (IMH) by revealing extensive aortic wall thickening.
  • Surgical confirmation validated the TEE findings of ascending aorta aneurysm and IMH.

Implications:

  • This case underscores the importance of considering IMH in the differential diagnosis of acute chest pain, even without classic intimal flap signs.
  • Advanced imaging modalities like TEE are vital for diagnosing complex aortic pathologies.
  • Early surgical intervention is critical for managing type A IMH to prevent catastrophic outcomes.