Fozzato Francesca, Prioli Maria Antonia, Santini Francesco, Menini Fabio, Pavan Michela, Guarise Paola, Vassanelli Corrado
Divisione di Cardiologia, Ospedale Civile Maggiore, Verona.
G Ital Cardiol (Rome). 2010 Feb;11(2):162-4.
Aortic intramural hematoma is a life-threatening thoracic aortic pathology. In this report we describe a case of fissuration of an aortic intramural hematoma with atypical clinical presentation, which occurred in an aircraft pilot. The patient was admitted to our emergency room with transient chest pain developed during a flight landing, followed only by persistent abdominal pain. The ECG and cardiac enzymes were normal. A portable two-dimensional transthoracic echocardiogram showed aortic root dilation and pericardial effusion. Transesophageal echocardiography showed aortic intramural hematoma with fissuration into the pericardial space. The angio-computed tomography confirmed the diagnosis. Two hours after admission the patient, with signs of cardiac tamponade, underwent Bentall surgical intervention without complications.
主动脉壁内血肿是一种危及生命的胸主动脉病变。在本报告中，我们描述了一例主动脉壁内血肿破裂且临床表现不典型的病例，该病例发生在一名飞机驾驶员身上。患者因飞行着陆期间出现短暂胸痛后仅持续存在腹痛而被送入我们的急诊室。心电图和心肌酶均正常。便携式经胸二维超声心动图显示主动脉根部扩张和心包积液。经食管超声心动图显示主动脉壁内血肿并破裂至心包腔。血管计算机断层扫描证实了诊断。入院两小时后，患者出现心脏压塞体征，接受了Bentall手术干预，无并发症发生。
