case_images: PMC6881564_01
case_images: EKG showing occasional ventricular premature complexes, left ventricular hypertrophy, with nonspecific ST-segment, T-wave changes.
case_images: CRIRA2019-6545472.001.jpg
case_images: PMC6881564_01_CRIRA2019-6545472.001.jpg
case_images: fig1
case_images: Electrocardiogram (EKG) showed sinus rate at 63 bpm with occasional ventricular premature complexes, left ventricular hypertrophy and nonspecific ST-segment, T-wave changes (Figure 1).
case_images: CXR showing widened mediastinum (arrows), enlarged cardiomediastinal silhouette and longitudinal retrocardiac opacity.
case_images: CRIRA2019-6545472.002.jpg
case_images: PMC6881564_01_CRIRA2019-6545472.002.jpg
case_images: fig2
case_images: The chest X-ray (CXR) showed a widened mediastinum, enlarged cardiomediastinal silhouette, and longitudinal retrocardiac opacity which was noted by the radiologist to possibly reflect a thoracic aortic aneurysm (Figure 2).
case_images: Axial CT image of the thorax without contrast showing aneurysmal dilatation (arrow) of the ascending thoracic aorta.
case_images: CRIRA2019-6545472.003.jpg
case_images: PMC6881564_01_CRIRA2019-6545472.003.jpg
case_images: fig3
case_images: The CT showed aneurysmal dilatation of the ascending thoracic aorta, measuring up to 4.5 cm in the axial image (Figure 3).
case_images: Parasternal long axis view showing the dissection flap (arrows) in the ascending aorta.
case_images: CRIRA2019-6545472.004.jpg
case_images: PMC6881564_01_CRIRA2019-6545472.004.jpg
case_images: fig4
case_images: From the data above (aortic dissection detection risk score of 1), and given the fact that the Troponin I levels were uptrending, (1.340 ng/mL-1.430 ng/mL), evaluation for dissection was undertaken initially utilizing a bedside transthoracic echocardiogram (TTE) which identified an ascending aortic/aortic root aneurysm with a dissection flap (Figures 4-9).
case_images: Parasternal long axis view showing aortic insufficiency (arrows).
case_images: CRIRA2019-6545472.005.jpg
case_images: PMC6881564_01_CRIRA2019-6545472.005.jpg
case_images: fig5
case_images: From the data above (aortic dissection detection risk score of 1), and given the fact that the Troponin I levels were uptrending, (1.340 ng/mL-1.430 ng/mL), evaluation for dissection was undertaken initially utilizing a bedside transthoracic echocardiogram (TTE) which identified an ascending aortic/aortic root aneurysm with a dissection flap (Figures 4-9).
case_images: Parasternal long axis view showing the ascending aortic aneurysm.
case_images: CRIRA2019-6545472.006.jpg
case_images: PMC6881564_01_CRIRA2019-6545472.006.jpg
case_images: fig6
case_images: From the data above (aortic dissection detection risk score of 1), and given the fact that the Troponin I levels were uptrending, (1.340 ng/mL-1.430 ng/mL), evaluation for dissection was undertaken initially utilizing a bedside transthoracic echocardiogram (TTE) which identified an ascending aortic/aortic root aneurysm with a dissection flap (Figures 4-9).
case_images: Suprasternal notch view showing the dissection flap extending to the aortic arch (arrow).
case_images: CRIRA2019-6545472.007.jpg
case_images: PMC6881564_01_CRIRA2019-6545472.007.jpg
case_images: fig7
case_images: From the data above (aortic dissection detection risk score of 1), and given the fact that the Troponin I levels were uptrending, (1.340 ng/mL-1.430 ng/mL), evaluation for dissection was undertaken initially utilizing a bedside transthoracic echocardiogram (TTE) which identified an ascending aortic/aortic root aneurysm with a dissection flap (Figures 4-9).
case_images: Color Doppler helps in appreciating the true lumen (arrows) from the false lumen.
case_images: CRIRA2019-6545472.008.jpg
case_images: PMC6881564_01_CRIRA2019-6545472.008.jpg
case_images: fig8
case_images: From the data above (aortic dissection detection risk score of 1), and given the fact that the Troponin I levels were uptrending, (1.340 ng/mL-1.430 ng/mL), evaluation for dissection was undertaken initially utilizing a bedside transthoracic echocardiogram (TTE) which identified an ascending aortic/aortic root aneurysm with a dissection flap (Figures 4-9).
case_images: Parasternal long axis view showing dissection flap prolapsing (arrow) into the left ventricular outflow tract causing aortic insufficiency.
case_images: CRIRA2019-6545472.009.jpg
case_images: PMC6881564_01_CRIRA2019-6545472.009.jpg
case_images: fig9
case_images: From the data above (aortic dissection detection risk score of 1), and given the fact that the Troponin I levels were uptrending, (1.340 ng/mL-1.430 ng/mL), evaluation for dissection was undertaken initially utilizing a bedside transthoracic echocardiogram (TTE) which identified an ascending aortic/aortic root aneurysm with a dissection flap (Figures 4-9).