Department of Cardiovascular Surgery, Beijing Anzhen Hospital, Capital Medical University, Beijing Institute of Heart, Lung and Blood Vessel Diseases, 2 Anzhen Rd, Chaoyang District, Beijing, 100029, China.
BMC Cardiovasc Disord. 2020 Apr 6;20(1):162. doi: 10.1186/s12872-020-01440-1.
Aortic intramural hematoma is a life-threatening condition reported with increasing frequency. It can be classified into Stanford type A or B depending on whether the ascending or descending aorta are involved, respectively. However, the onset of acute type A aortic dissection following recovery of type B intramural haematoma is rarely reported.
We present an uncommon case of acute Stanford type A aortic dissection developing 3 months after recovery of type B IMH in a 47-year-old female. She complained acute chest pain. The operation was successfully done. She was in good condition and asymptomatic at a 3-month follow-up.
Type B intramural haematoma can lead to type A aortic dissection even after totally absorbed and the primary entry has the potential to be located in the ascending aorta. Unsatisfied blood pressure control may be the underlying cause.
主动脉壁内血肿是一种危及生命的疾病，其发病率呈上升趋势。根据病变累及的升主动脉或降主动脉，可将其分为 Stanford A 型或 B 型。然而，Stanford B 型主动脉壁内血肿恢复后发生急性 Stanford A 型主动脉夹层的情况很少见。
我们报告了一例罕见的病例，一名 47 岁女性在 Stanford B 型主动脉壁内血肿完全吸收后 3 个月发生急性 Stanford A 型主动脉夹层。她诉胸痛。手术成功完成。她在 3 个月的随访中状况良好，无症状。
Stanford B 型主动脉壁内血肿即使完全吸收后也可能导致 Stanford A 型主动脉夹层，且原发入口可能位于升主动脉。血压控制不理想可能是潜在的原因。
