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Aortitis masquerading as intramural hematoma: When to observe, when to operate? A case report. J Card Surg 2021 Apr;36(4):1554-1556

Date

01/28/2021

Pubmed ID

33502772

DOI

10.1111/jocs.15348

Scopus ID

2-s2.0-85099926135 (requires institutional sign-in at Scopus site)   1 Citation

Abstract

Radiologic evidence of aortic disease is not always consistent with the diagnosis. With a lack of accompanying symptoms or with an atypical presentation, diagnosis, and management of aortic pathology rely greatly on imaging techniques. We report the case of a 58-year-old female who presented with incidental radiographic findings consistent with a type A aortic intramural hematoma and a vague left-sided chest discomfort. After follow-up, imaging was consistent with disease progression and hematoma expansion; the affected segment was resected and pathology reported lymphoplasmacytic aortitis as the underlying etiology of the imaging findings rather than an intramural hematoma. The patient lacked symptoms or serology consistent with the rheumatologic disease, and the postoperative course was uneventful. The management of a suspected ascending intramural hematoma is controversial, especially when the patient presents with atypical signs and symptoms. Features of disease progression may warrant urgent surgical intervention.

Author List

Velez AK, Etchill E, Halushka MK, Schena S

Author

Stefano Schena MD, PhD Associate Professor in the Surgery department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Aorta
Aortic Diseases
Aortitis
Diagnostic Imaging
Female
Hematoma
Humans
Middle Aged