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A Case of Chronic Aortic Dissection With Hemopericardium and Tamponade

Athanasios Pavlou1,2, Laura Cardenas Ramos1,2, Martin Vanek1,2

  • 1Internal Medicine, St. Vincent's Medical Center, Bridgeport, USA.

Cureus
|May 9, 2022
PubMed

Insights

Chronic Type A aortic dissection, a rare condition, can present with delayed symptoms like shortness of breath and leg swelling. This case highlights a chronic ascending aorta dissection complicated by cardiac tamponade.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Medical Diagnostics

Background:

  • Type A aortic dissection involves a tear in the ascending aorta, leading to lumen separation.
  • While typically acute, chronic dissections can present insidiously with less severe symptoms over time.

Observation:

  • An 88-year-old patient presented with a 2-3 week history of orthopnea and leg swelling.
  • Imaging revealed a chronic dissection of the ascending aorta.

Findings:

  • The chronic aortic dissection was complicated by hemopericardium, resulting in cardiac tamponade.
  • This presentation of chronic Type A aortic dissection with tamponade is exceptionally rare in medical literature.

Implications:

  • Clinicians should consider chronic aortic dissection in elderly patients with prolonged, moderate symptoms.
  • This case underscores the importance of thorough diagnostic evaluation for aortic pathologies, even with delayed presentations.
  • Further research into the natural history and management of chronic aortic dissections is warranted.
Keywords:
aortic dissectioncardiac tamponadeechocardiographyhemopericardiumorthopnea

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