Caro C, Cáceres G, García Cosío F
Med Clin (Barc). 1980 Jun 25;75(2):75-8.
Two cases of leakage of an aortic dissecting aneurysm into the pericardial cavity presenting as acute pericarditis are reported. In both cases the existence of risk factors (hypertension and coarctation of the aorta) suggested the correct diagnosis. Echocardiography showed enlargement of the ascending aorta and thickening of vascular wall in the two cases, furthermore it suggested the presence of aortic insufficiency in one case. The definite diagnosis was made by means of aortography. One patient died after surgery, while the other was successfully treated with hypotensive drugs. Dissecting aneurysm of the aorta may present atypical clinical manifestations; in these circumstances a great suspicion index is the basis for a correct diagnosis. The importance of an early diagnosis by means of aortography and echocardiography is emphasized.
报告了两例主动脉夹层动脉瘤破入心包腔并表现为急性心包炎的病例。在这两例中,危险因素(高血压和主动脉缩窄)的存在提示了正确的诊断。超声心动图显示两例患者升主动脉增宽和血管壁增厚,此外,其中一例提示存在主动脉瓣关闭不全。通过主动脉造影做出了明确诊断。一名患者术后死亡,而另一名患者通过降压药物成功治疗。主动脉夹层动脉瘤可能表现出非典型的临床表现;在这些情况下,高度的怀疑指数是正确诊断的基础。强调了通过主动脉造影和超声心动图进行早期诊断的重要性。