Medical image of the week: acute aortic dissection

Abstract

The patient was a 75 year old woman with a past medical history of uncontrolled hypertension and recent type-A aortic dissection post graft repair. She presented with a sudden onset of sharp mid-back pain which awoke her from sleep. In the emergency room a chest x-ray revealed numerous features consistent with a de novo type B aortic dissection which was ultimately confirmed by magnetic resonance angiography of the chest and abdomen. This dissection extended from the left subclavian artery to the right renal artery. There was no evidence of end-organ mal-perfusion and the patient was medically managed by way of blood pressure control.

Keywords

• aortic dissection
• tracheal deviation
• apical capping
• double-calcium sign
• left bronchus
• widenened mediastinum
• pleural effusion
• aorto-pulmonary window
• chest pain
• hypertension