Related Experiment Video
Updated: Jan 10, 2026

Cardiac Magnetic Resonance for the Evaluation of Suspected Cardiac Thrombus: Conventional and Emerging Techniques
Published on: June 11, 2019
IgG4-Related Aortitis Masking as Intramural Hematoma on Imaging
Armaan F Akbar1, Atharv Oak2, Uzma Rahman3
1Department of Cardiac Surgery, Columbia University, New York, New York, USA.
Background:
IgG4-related aortitis is a rare fibroinflammatory disease characterized by thoracic or abdominal aortic wall thickening and dilation.
Case Summary:
A 24-year-old man presented after blunt trauma and was found to have intramural hematoma in the ascending aorta on chest computed tomography. Given the high-impact injury, aortic injury could not be excluded. Therefore, he underwent a hemiarch replacement; intraoperative findings and histopathology were concerning for IgG4-related aortitis.
Discussion:
IgG4 aortitis of the ascending aorta is rare, with only a few case reports in the literature. On computed tomography, IgG4 aortitis can mimic acute aortic syndrome, which poses a challenge regarding appropriate management.
Take-Home Messages:
IgG4 aortitis can mimic acute aortic syndrome findings on imaging. This poses a clinical dilemma in the management of these patients, and surgical intervention should only be offered in the appropriate clinical scenario.
More Related Videos
Related Concept Videos
Aneurysm III: Interprofessional Care
Imaging Studies for Cardiovascular System IV: CMRI
Aneurysm II: Clinical Manifestations and Diagnostic Studies
Aortic Regurgitation II: Clinical Features and Diagnostic Tests

