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Ruptured aortic dissection presenting with new onset atrial fibrillation

Rei-Yeuh Chang1, Chung-Ben Kan, Yuan-Horng Yan

  • 1Division of Cardiology, Department of Internal Medicine, Ditmanson Medical Foundation Chia-Yi Christian Hospital, Chiayi, Taiwan.

BMJ Case Reports
|November 24, 2012
PubMed

Insights

Type A aortic dissection involving the entire thoracic aorta can present with new-onset atrial fibrillation. This rare presentation may stem from hematoma compression of the left atrium.

Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Vascular Medicine

Background:

  • Type A aortic dissection (TAAD) is a life-threatening condition involving the ascending aorta.
  • Atrial fibrillation (AF) is a common cardiac arrhythmia.
  • The coexistence of TAAD and new-onset AF is infrequently reported.

Observation:

  • A case of TAAD affecting both the ascending and descending thoracic aorta is presented.
  • The patient exhibited new-onset atrial fibrillation as a primary symptom.
  • Computed tomography (CT) imaging was crucial for diagnosing the aortic dissection.

Findings:

  • The dissection extended from the ascending to the descending thoracic aorta.
  • The patient developed new-onset atrial fibrillation.
  • A large hematoma associated with the dissection was identified as a potential cause of left atrial compression.

Implications:

  • This case highlights an unusual presentation of TAAD.
  • It suggests that aortic hematoma can directly impact cardiac function and lead to arrhythmias.
  • Clinicians should consider aortic dissection in patients with new-onset atrial fibrillation, especially when other risk factors are present.

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