Diagnosis of fast-growing thoracic aneurysm with microscopic evidence of dissection over 6 months follow-up in an asymptomatic middle aged gentleman: a case report

Abstract

Abstract Background Thoracic aortic aneurysm (TAA), is a pathological dilatation of the aortic segment with the tendency to expand, dissect or rupture, and risk of mortality. The progression rate is mainly slow. As the risk of rupture increases with the size of the aortic diameter, it is important to diagnose TAA appropriately to prevent mortality. Case presentation Here, we present a case with a fast-growing TAA, complicated by subclinical dissection in a middle-aged gentleman, associated with non-compaction left ventricle, diagnosed 6 months after the first diagnosis of this co-occurrence, successfully managed by an uneventful surgical procedure. The pathological examination was the key to the diagnosis of this concealed phenomenon, i.e. a fast-growing aortic aneurysm complicated by subclinical dissection. Conclusion This case report emphasizes the importance of close follow-up of patients with fast-growing TAA for considering remote possibility of this silent life-threatening disease; subclinical dissecting aneurysm, especially in patients with other cardiac comorbidities. Although imaging modalities can help accurate diagnosis, in cases with fast-growing TAA, we should not wait for imaging signs of dissection and/or rupture.

Keywords

• Isolated non-compaction of the ventricular myocardium
• Aortic aneurysm
• Non-compaction of left ventricular myocardium with congenital heart defects
• Fast-growing aortic aneurysm
• Subclinical dissecting aneurysm