Korean J Thorac Cardiovasc Surg.  2010 Apr;43(2):194-198.

Delayed Diagnosis of Cardiac Tamponade That Was Caused by Intramural Hematoma of the Ascending Aorta: A case report

• Hwang YH
• Song SW
• Yi G

Abstract

Intramural hematoma of the aorta (IMH) is the precursor or a variant of a classic aortic dissection where hemorrhage occurs within the aorta wall in the absence of an initial intimal tear. IMH has a high rate of mortality and morbidity. The optimal therapy for IMH is uncertain, yet the involvement of the ascending aorta is usually considered as an indication for surgery due to the associated risk of rupture or cardiac tamponade. We report here on a case of a 71-year-old man who presented with syncope. Because of misdiagnosis, he underwent computed tomography (CT) after 5 hrs from arriving to the ER. Computed tomography of the aorta revealed intramural hematoma of the ascending aorta with cardiac tamponade. He also had vascular complications such as acute renal failure and visceral ischemia. We performed emergency graft replacement of the total arch and ascending aorta. He was discharged without complication on postoperative day 14.

Keyword

Aorta, surgery; Cardiac tamponade

MeSH Terms

Acute Kidney Injury
Aged
Aorta
Cardiac Tamponade
Delayed Diagnosis
Diagnostic Errors
Emergencies
Hematoma
Hemorrhage
Humans
Ischemia
Rupture
Syncope
Transplants