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The Dynamic Evolution of Aortic Intramural Hematoma
Xun Yuan1,2, Jeffrey Shi Kai Chan3,4, Andreas Mitsis1
1Cardiology and Aortic Centre, Royal Brompton Hospital and Harefield NHS Foundation Trust, Imperial College London, London, United Kingdom.
JACC. Case Reports
|July 28, 2021
Summary
Aortic intramural hematoma progressed to a penetrating aortic ulcer and dissection in a 64-year-old man. Treatment involved blood pressure control and thoracic endovascular aortic repair, leading to successful discharge.
Area of Science:
- Cardiovascular Medicine
- Vascular Surgery
- Diagnostic Imaging
Background:
- Aortic intramural hematoma (IMH) is a serious cardiovascular condition.
- Early diagnosis and management are crucial for preventing complications.
- Progression to more severe aortic pathologies can occur.
Observation:
- A 64-year-old male presented with acute chest pain.
- Computed tomography (CT) identified an aortic intramural hematoma.
- The hematoma showed progression over 30 days.
Findings:
- The aortic intramural hematoma evolved into a penetrating aortic ulcer by day 7.
- Further progression led to aortic dissection by day 30.
- The patient received medical management for strict blood pressure control.
Implications:
- Thoracic endovascular aortic repair (TEVAR) is an effective treatment option for complex aortic events.
- Timely intervention can lead to favorable patient outcomes.
- This case highlights the importance of vigilant monitoring of aortic intramural hematoma.
Keywords:
TEVARacute aortic syndromeintramural hematomapenetrating atherosclerotic ulcertype B aortic dissectionMore Related Videos
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