Coombes Kyle, Moin Kayvon, Ahmed-Khan Mohammad A, Vargas Jonathan
Medical School, American University of the Caribbean, Cupecoy, SXM.
Medicine, CMH Lahore Medical College and Institute of Dentistry, Lahore, PAK.
Cureus. 2022 Dec 26;14(12):e32947. doi: 10.7759/cureus.32947. eCollection 2022 Dec.
Aortic intramural hematoma (AIH) is a life-threatening emergency that involves aortic wall integrity and is characterized by either a direct rupture of the vasa vasorum or spontaneous bleeding of an arterial plaque located in the tunica media of the aortic wall. A notable difference between AIH and acute aortic dissection is the absence of an intimal flap, a finding discernable on computed tomography angiography (CTA). Follow-up imaging allows for the monitoring of disease progression or early findings of impending complications. While some patients may require surgical intervention, medical management with blood pressure control remains the mainstay in treatment. Our case describes a patient who was found to be in cardiac arrest secondary to ventricular fibrillation and was then found to have presumed Stanford Type A aortic dissection on CTA. After reviewing the scans, the diagnosis was reclassified to AIH due to the absence of an intimal flap, the patient was then managed medically for AIH with antihypertensive medications.
主动脉壁内血肿（AIH）是一种危及生命的急症，涉及主动脉壁完整性，其特征是滋养血管直接破裂或位于主动脉壁中膜的动脉粥样斑块自发性出血。AIH与急性主动脉夹层的一个显著区别是没有内膜瓣，这一发现可在计算机断层血管造影（CTA）上辨别出来。随访成像有助于监测疾病进展或早期发现即将出现的并发症。虽然一些患者可能需要手术干预，但控制血压的药物治疗仍然是主要的治疗方法。我们的病例描述了一名患者，该患者因心室颤动继发心脏骤停，随后在CTA上被诊断为疑似斯坦福A型主动脉夹层。在复查扫描后，由于没有内膜瓣，诊断重新分类为AIH，然后该患者接受了AIH的药物治疗，使用了抗高血压药物。
