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[Chronic aortic dissection disclosed by pericardial effusion. Apropos of 3 cases]
P de Groote1, A Millaire, C Caron
1Service de cardiologie C, hôpital cardiologique, Lille.
Insights
Three patients with chronic aortic dissection were diagnosed due to pericardial effusion. Prompt drainage and CT scans are crucial for identifying this rare presentation of aortic dissection.
Area of Science:
- Cardiology
- Thoracic Surgery
- Diagnostic Imaging
Background:
- Aortic dissection is a serious cardiovascular condition.
- Pericardial effusion can be a rare presenting sign of aortic dissection.
- Misdiagnosis can occur with initial symptoms like chest pain or fever.
Observation:
- Three patients presented with thoracic pain or fever, initially diagnosed with myocardial infarction, infective endocarditis, or tuberculous pericarditis.
- Pericardial effusions were drained, revealing a sero-hematic fluid.
- Computed tomography (CT) scans of the thorax and abdomen were performed due to the nature of the pericardial fluid.
Findings:
- All three cases were diagnosed with chronic aortic dissection.
- Two cases were type II aortic dissection, and one was type III.
- Retrograde extension to the ascending aorta was noted in the diagnosed cases.
Implications:
- This case series highlights the importance of considering aortic dissection in patients with unexplained sero-hematic pericardial effusion.
- Drainage of pericardial effusion can be diagnostic.
- Systematic CT imaging is essential for accurate diagnosis in such cases.
Abstract:
Three exceptional cases of chronic aortic dissection revealed by a pericardial effusion are reported. The patients were two men and a woman admitted for thoracic pain or fever. Initial diagnoses were myocardial infarction, infective endocarditis and tuberculous pericarditis. The effusions were drained on two occasions. Because the pericardial fluid was a mixture of serum and blood, computerized tomography of the thorax and abdomen was performed. All three cases were then diagnosed as aortic dissection (type II in two cases and type III in one case, with retrograde extension to the ascending aorta). The authors underline the utility of drainage and the need for systematic CT scans in patients with sero-haematic pericardial effusion of uncertain origin.