Beckmann Erik, Dalia Adam A, Jelly Christina A, Melnitchouk Serguei
Division of Cardiothoracic Surgery, Department of Surgery, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Interact Cardiovasc Thorac Surg. 2019 Mar 1;28(3):491-492. doi: 10.1093/icvts/ivy268.
Intramural haematoma and penetrating atherosclerotic ulcer belong to the group of acute aortic syndromes. The combined presentation of both intramural haematoma and a penetrating atherosclerotic ulcer in the ascending aorta is a very rare finding. Here, we present the case of a 72-year-old female, who was admitted to our centre with acute chest and back pain. She was diagnosed with type A intramural haematoma secondary to a penetrating atherosclerotic ulcer of the ascending aorta, and she underwent subsequent emergent surgical management. The diagnosis was confirmed intraoperatively and histopathologically. This case depicts the dynamic pathophysiological development of acute aortic syndromes and the finding that different entities of acute aortic syndromes may evolve or lead to another.
壁内血肿和穿透性动脉粥样硬化溃疡属于急性主动脉综合征。升主动脉同时存在壁内血肿和穿透性动脉粥样硬化溃疡的情况非常罕见。在此，我们报告一例72岁女性病例，该患者因急性胸痛和背痛入院。她被诊断为升主动脉穿透性动脉粥样硬化溃疡继发A型壁内血肿，并随后接受了急诊手术治疗。术中及组织病理学检查确诊了该诊断。本病例描述了急性主动脉综合征动态的病理生理发展过程，以及不同类型的急性主动脉综合征可能相互演变或导致另一类型的发现。
