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Patient with severe dorsal chest pain unresponsive to pharmacological treatment

    Author: Christian Loewe, Vienna, Austria
    Body Region: Cardiovascular

    1. Patient Presentation
    2. CT Images
    3. CT Findings
    4. Further patient management / treatment
    5. References
    CT angiography case of Stanford type B aortic dissection with retrograde intramural hematoma involving the thoracic aorta, treated with TEVAR.

    1. Patient Presentation

    • A 73-year-old male patient was referred to the hospital because of severe dorsal chest pain with reported onset a few hours earlier.
    • Upon admission, the patient was hypertensive but in stable circulatory condition, and experiencing severe chest pain that could not be controlled pharmacologically.
    • The ECG and initial laboratory values were nonspecific, showing no signs of acute myocardial infarction.
    • Echocardiography revealed a substantial pericardial effusion with increased echogenicity, highly suspicious for hemopericardium.
    • Consequently, owing to the patient’s symptoms and condition, an urgent CT angiography was performed for suspected acute aortic syndrome.
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