Delayed Diagnosis of Cardiac Tamponade That Was Caused by Intramural Hematoma of the Ascending Aorta: A case report.
- Author:
Yoo Hwa HWANG
1
;
Suk Won SONG
;
Gijong YI
Author Information
1. Department of Thoracic and Cardiovascular Surgery, Severance Hospital, Yonsei University College of Medicine, Korea.
- Publication Type:Case Report
- Keywords:
Aorta, surgery;
Cardiac tamponade
- MeSH:
Acute Kidney Injury;
Aged;
Aorta;
Cardiac Tamponade;
Delayed Diagnosis;
Diagnostic Errors;
Emergencies;
Hematoma;
Hemorrhage;
Humans;
Ischemia;
Rupture;
Syncope;
Transplants
- From:The Korean Journal of Thoracic and Cardiovascular Surgery
2010;43(2):194-198
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Intramural hematoma of the aorta (IMH) is the precursor or a variant of a classic aortic dissection where hemorrhage occurs within the aorta wall in the absence of an initial intimal tear. IMH has a high rate of mortality and morbidity. The optimal therapy for IMH is uncertain, yet the involvement of the ascending aorta is usually considered as an indication for surgery due to the associated risk of rupture or cardiac tamponade. We report here on a case of a 71-year-old man who presented with syncope. Because of misdiagnosis, he underwent computed tomography (CT) after 5 hrs from arriving to the ER. Computed tomography of the aorta revealed intramural hematoma of the ascending aorta with cardiac tamponade. He also had vascular complications such as acute renal failure and visceral ischemia. We performed emergency graft replacement of the total arch and ascending aorta. He was discharged without complication on postoperative day 14.
