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Aortitis masquerading as intramural hematoma: When to observe, when to operate? A case report
Author(s) -
Velez Ana K.,
Etchill Eric,
Halushka Marc K.,
Schena Stefano
Publication year - 2021
Publication title -
journal of cardiac surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.428
H-Index - 58
eISSN - 1540-8191
pISSN - 0886-0440
DOI - 10.1111/jocs.15348
Subject(s) - medicine , hematoma , aortitis , etiology , presentation (obstetrics) , radiology , disease , surgery , radiography , aorta , pathology
Radiologic evidence of aortic disease is not always consistent with the diagnosis. With a lack of accompanying symptoms or with an atypical presentation, diagnosis, and management of aortic pathology rely greatly on imaging techniques. We report the case of a 58‐year‐old female who presented with incidental radiographic findings consistent with a type A aortic intramural hematoma and a vague left‐sided chest discomfort. After follow‐up, imaging was consistent with disease progression and hematoma expansion; the affected segment was resected and pathology reported lymphoplasmacytic aortitis as the underlying etiology of the imaging findings rather than an intramural hematoma. The patient lacked symptoms or serology consistent with the rheumatologic disease, and the postoperative course was uneventful. The management of a suspected ascending intramural hematoma is controversial, especially when the patient presents with atypical signs and symptoms. Features of disease progression may warrant urgent surgical intervention.