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Published on: November 24, 2016
Spontaneous innominate artery rupture in a patient with systemic sclerosis
Sabreen Ali1, Michael DeVile2, Rodney Hughes1
1Department of Rheumatology, Ashford and St Peter's NHS Hospitals Trust, Chertsey, United Kingdom.
Abstract:
We present the case of a 57-year-old female with systemic sclerosis who presented in extremis to our hospital with an acute onset of right upper chest and neck pain with swelling. She deteriorated rapidly due to haemodynamic compromise from suspected bleeding and suffered a cardiac arrest with prolonged resuscitation. Emergency thoracotomy demonstrated an acute longitudinal tear of the innominate artery/brachiocephalic trunk at the junction of the subclavian and common carotid arteries. This is the first reported case of spontaneous arterial rupture in a patient with systemic sclerosis, and while direct causation is difficult to prove, her history of previous vascular complications with potential ongoing microvascular damage makes a contributory role likely.
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