An unusual case of painless type A aortic dissection

J Clin Ultrasound. 2021 Sep;49(7):682-685. doi: 10.1002/jcu.22974. Epub 2021 Jan 12.

Abstract

The pathogenesis of acute aortic dissection (AAD) is not fully elucidated yet, but it was recently shown that inflammation contributes to the occurrence and development of both Stanford type A and type B AAD. We describe a rare case of a painless type A aortic dissection that occurred in an 85-year-old male, with moderate calcified aortic stenosis and a moderately dilated ascending aorta in 6-month clinical and echocardiographic follow-up. A chronic calculous cholecystitis with neutrophilic leukocytosis and severely increased C reactive protein was diagnosed in the last 3 months. In this patient, a chronic systemic inflammatory state might have contributed to generate the intimal entry tear in the aortic root. In particular, a neutrophil mobilization might have played a causative role in aortic rupture.

Keywords: echocardiography; inflammation; painless acute aortic dissection.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Aged, 80 and over
  • Aorta / diagnostic imaging
  • Aortic Aneurysm, Thoracic*
  • Aortic Dissection* / diagnostic imaging
  • Aortic Rupture*
  • Dilatation, Pathologic
  • Echocardiography
  • Humans
  • Male