An extensive DeBakey type IIIb aortic dissection with massive right pleural effusion presenting as abdominal pain and acute anemia:particular case report
10.11909/j.issn.1671-5411.2015.03.010
- Author:
Huichun YU
;
Zhenqing WANG
;
Yuanyuan HAO
;
Fengping AN
;
Yuchuan HU
;
Ruibing DENG
;
Peng YU
;
Guangbin CUI
;
He LI
- Publication Type:Journal Article
- Keywords:
Acute aortic dissection;
Anemia;
D-dimer;
The elderly
- From:
Journal of Geriatric Cardiology
2015;(3):319-322
- CountryChina
- Language:Chinese
-
Abstract:
We describe the case of a 79-year-old male presented with sudden onset of abdominal pain and mild breathlessness, and complicated acute progressive anemia with haemoglobin which declined from 120 g/L to 70 g/L within five days. An urgent computed tomography an-giography showed acute thoracic aortic dissection, DeBakey type IIIb, a dissecting aneurysm in the proximal descending thoracic aorta start-ing immediately after the origin of the left subclavian artery and extending distally below the renal arteries with evidence of rupture into the right pleural cavity for massive pleural effusion. Plasma D-dimer, brain natriuretic peptide and C reactive protein level were elevated. Our case showed that D-dimer can be used as a‘rule-out’ test in patients with suspected aortic dissection. A raised BNP may exert a protective role through anti-inflammatory endothelial actions in the systemic circulation.
