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Ruptured thoracic aneurysm presenting as dyspnea and hypotension
1Department of Emergency Medicine, Wright State University School of Medicine, Dayton, Ohio 45401.
Annals of Emergency Medicine
|July 1, 1988
Summary
A ruptured thoracic aortic aneurysm presented atypically with back pain and respiratory distress. Diagnostic thoracentesis confirmed hemothorax, leading to successful surgical repair of the descending thoracic aortic aneurysm.
Area of Science:
- Cardiology
- Thoracic Surgery
- Pulmonology
Background:
- The patient had a history of chronic obstructive lung disease and hypertension.
- She presented with acute symptoms including back pain, dyspnea, tachypnea, hypotension, and tachycardia.
Observation:
- Physical examination revealed unilateral diminished breath sounds and wheezing.
- A portable chest radiograph showed a large left pleural effusion.
- Thoracentesis confirmed hemothorax, and angiography revealed a 7-cm descending thoracic aortic aneurysm.
Findings:
- The patient underwent successful surgical resection and Dacron graft repair of the aneurysm.
- This case highlights an atypical presentation of a ruptured thoracic aortic aneurysm.
Implications:
- Emphasizes the importance of considering thoracic aneurysms in patients with unexplained pleural effusions and respiratory distress.
- Highlights the diagnostic utility of thoracentesis for effusions of unknown etiology.
- Underscores the need for a high index of suspicion for atypical presentations of ruptured thoracic aortic aneurysms.