Momentary and wide aortic regurgitation as an indicator of aortic dissection

A 55-year-old female with a history of hypertension was admitted for dyspnea, epigastralgia and nausea. A chest X-ray showed pulmonary congestion. Transthoracic echocardiography (TTE) revealed severe left ventricular dysfunction with akinesis of the infero-posterior wall and Doppler color-flow mode...

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Bibliographic Details
Published in:General thoracic and cardiovascular surgery 2017-03, Vol.65 (3), p.167-170
Main Authors: Inokuchi, Takafumi, Sasaki, Osamu, Nishioka, Toshihiko, Ito, Hiroyuki, Yoshimoto, Nobuo, Yamabi, Hideaki, Imanaka, Kazuhito, Sasaki, Hideki
Format: Article
Language:English
Subjects:
Aneurysm, Dissecting - complications
Aneurysm, Dissecting - diagnosis
Aortic Aneurysm, Thoracic - complications
Aortic Aneurysm, Thoracic - diagnosis
Aortic dissection
Aortic Valve Insufficiency - diagnosis
Aortic Valve Insufficiency - etiology
Cardiac arrhythmia
Cardiac Surgery
Cardiology
Case Report
Conflicts of interest
Coronary vessels
Diagnosis, Differential
Doppler effect
Echocardiography
Electrocardiography
Emergency medical care
Female
Heart attacks
Heart failure
Heart rate
Humans
Medicine
Medicine & Public Health
Middle Aged
Patients
Surgical Oncology
Thoracic Surgery
Ultrasonic imaging
Veins & arteries
Ventilation
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Summary:A 55-year-old female with a history of hypertension was admitted for dyspnea, epigastralgia and nausea. A chest X-ray showed pulmonary congestion. Transthoracic echocardiography (TTE) revealed severe left ventricular dysfunction with akinesis of the infero-posterior wall and Doppler color-flow mode showed mild aortic regurgitation (AR). Noninvasive positive pressure ventilation, intravenous heparin and diuretics were administered. Follow-up TTE revealed a dissection flap as well as momentary and wide AR only during isovolumetric relaxation. Contrast-enhanced computed tomography of the chest revealed Stanford type A aortic dissection. A momentary and wide AR in echocardiograms might serve as an important and useful indicator of aortic dissection in patients with acute myocardial infarction and congestive heart failure.
ISSN:1863-6705
1863-6713
DOI:10.1007/s11748-015-0595-y