China
Africa
Explore chapters and articles related to this topic
Aortic Disease
Published in Paul Schoenhagen, Frank Dong, Cardiac CT Made Easy, 2023
CT imaging plays a critical role in the diagnosis and management of AAS.132 Acute aortic syndrome is a clinical term describing an acute aortic pain syndrome associated with acute, life-threatening aortic diseases (in analogy to the term ‘acute coronary syndrome’), and encompasses several different entities.133 Classic aortic dissection describes a splitting or separation of the aortic wall within the media layer of the aorta. The pathological substrate that predisposes the aorta for dissection is an abnormal media layer, which is traditionally described as ‘cystic medianecrosis.’134 Medial degeneration can be caused by several entities, including congenital and genetic disorders (Marfan syndrome, Ehlers Danlos Type IV, aortitis), but is most commonly associated with severe, long-standing hypertension.
Aorta
Published in Takahiro Shiota, 3D Echocardiography, 2020
Intramural hematoma is another cause of acute aortic syndrome and is characterized by a hematoma in the media of the aortic wall without a dissection flap and false lumen.3,6 The imaging hallmark of an intramural hematoma is a localized and crescent-shaped aortic wall thickening greater than 5 mm. As with a penetrating aortic ulcer, an intramural hematoma has a risk of subsequent aortic dissection and true or pseudo-aortic aneurysm.5 Multidetector CT with and without contrast enhancement and cardiac magnetic resonance are the best imaging modalities to diagnose intramural hematoma. TEE is also valuable for the diagnosis, especially when CT and magnetic resonance imaging are not available or are of low quality. However, 3D TEE may not add much in this scenario unless there is coexistence of other complicated aortic and aortic valve abnormalities.
The aorta and dissection
Published in Helen Rimington, John B. Chambers, Echocardiography, 2015
Helen Rimington, John B. Chambers
Acute aortic syndrome refers to the presentation with instantaneous onset chest pain often in patients with an underlying predisposition (e.g. Marfan syndrome, known aortic valve or aortic disease) and suggestive clinical findings (asymmetric pulses or blood pressure).
Spontaneous spleen rupture mimicking non-specific thoracic pain: A rare case in physiotherapy practice
Published in Physiotherapy Theory and Practice, 2023
Carla Sforza, Michele Margelli, Firas Mourad, Fabrizio Brindisino, John D. Heick, Filippo Maselli
To the authors’ knowledge, this is the first case report with the description of a physiotherapist’s clinical reasoning process of TP and abdominal pain due to a spontaneous rupture of the spleen. Although most cases of TP are benign and nonspecific, the underlying cause of this complaint may hide challenging serious pathology presentations (Henschke et al., 2013). Thoracic and referred pain to the upper quadrant, could be caused by visceral pathologies such as pulmonary (Emadi Koochak, Tabibian, and Rahimi Dehgolan, 2017), gastrointestinal, and cardio-circulatory systems. Among the potential conditions presented as abdominal pain, the possibility of an acute aortic syndrome may present as a potentially catastrophic condition including acute aortic dissection (Ohle, Anjum, Bleeker, and McIsaac, 2019).
Exercise parameters for the chronic type B aortic dissection patient: a literature review and case report
Published in Postgraduate Medicine, 2021
Donald C. DeFabio, Christopher J. DeFabio
The Stanford type A (TAD) involves the ascending aorta and Stanford type B (TBD) may involve the arch, descending or abdominal aorta. In the presence of an intimal tear a false lumen is created which may be fully or partially patent as well as fully or partially thrombosed. A fully thrombosed false lumen can be considered an intramural hematoma, even if an intimal tear is present, and is treated as a dissection based on location. A true intramural hematoma is believed to arise from rupture of the vasa vasorum, the blood vessels that penetrate the outer half of the aortic media. Characteristically, an intimal flap is absent, and there is no direct communication between true and false lumens. The clinical manifestations, predisposing factors, and mortality risks are similar for intramural hematoma and aortic dissection. Between 8% and 15% of cases with acute aortic syndrome manifest as intramural hematoma [1–3]
Acute type A aortic dissection – a review
Published in Scandinavian Cardiovascular Journal, 2020
Tomas Gudbjartsson, Anders Ahlsson, Arnar Geirsson, Jarmo Gunn, Vibeke Hjortdal, Anders Jeppsson, Ari Mennander, Igor Zindovic, Christian Olsson
Dissection of the aorta occurs when the aortic media is separated, usually by pulsatile flow that penetrates the intimal layer of the aortic wall [14] (Figure 1(b)). This allows blood to flow between the layers of the aortic wall, forcing the layers apart, creating a false lumen parallel to the native (i.e. true) aortic lumen (Figure 1(b)). Consequently, the false lumen can propagate in both directions from the tear of intima and affect most of its distal branches, including the coronary, cerebral, and mesenteric arteries [15]. Another―but less common―mechanism for aortic dissection is a bleeding into the aortic wall without an intimal tear, often called intramural hematoma [16]. Finally, traumatic dissections occur from tears of the intima secondary to injury, which is most often iatrogenic, such as during percutaneous coronary intervention (PCI), cardiac catheterization, arterial cannulation for cardiopulmonary bypass (CPB), cross-clamping of the aorta during open heart surgery, or during cardiovascular interventions, such as endovascular aneurysm repair (EVAR), transcatheter aortic valve implantation (TAVI), or insertion of an intra-aortic balloon-pump (IABP) [17,18]. Although it is debated, in most instances, the recommended treatment for intramural haematomas and iatrogenic dissections of the thoracic aorta is similar to that for the more common conventional and non-traumatic tear AATADs. Intramural haematoma, ruptured aneurysms and non-traumatic and iatrogenic dissections constitute what is collectively referred to as acute aortic syndrome (AAS) [16,17].