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This history is real, a patient in his 80´s with, AH, cardiac hypertensive disease, mild AO reg and peric eff, Admited in Miami at 2 am with sharp chest pain, evaluated by cardiology at 9 am, cardiac cath at 4 pm and stenting or right coronary artery, we are still waiting reports
Refered for control with echo 4 weeks later: check the anterior aortic wall on M mode and increased peric eff
We dont found segmental WMA
but: localized anterior wall hematoma
That has a to and fro flow
Urgently I return to his MD suggesting CT; surprisingly with the aortic root disease ther was another problem at the end of ascending Aorta
Part of axial views near the arch and near the aortic root
I paint in red in two photograms the abnormal area
In my humble opinion: maybe the pain was an acute aortic syndrome (near the arch) , and the disection in the anterior wall was iatrogenic. I will like to hear opinions about the best therapy in this case
@almasthela @MasriAhmadMD @AlexBJanjic @MigueldeBoedo @Dr_DanMD
@almasthela @MasriAhmadMD @AlexBJanjic @MigueldeBoedo @Dr_DanMD
