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Calcified Pleural Plaque Can Rupture Thoracic Aorta

2004; Lippincott Williams & Wilkins; Volume: 110; Issue: 14 Linguagem: Catalão

10.1161/01.cir.0000143633.89691.95

1524-4539

Takahiro Inoue, Tokushi Koga, Shigeru Kaseda, Yasuo Kaizuka, Nobuyuki Kawazoe, Seizo Sadoshima, Mituru Kinjo,

Infective Endocarditis Diagnosis and Management

HomeCirculationVol. 110, No. 14Calcified Pleural Plaque Can Rupture Thoracic Aorta Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBCalcified Pleural Plaque Can Rupture Thoracic Aorta Takahiro Inoue, MD, Tokushi Koga, MD, Shigeru Kaseda, MD, Yasuo Kaizuka, MD, Nobuyuki Kawazoe, MD, Seizo Sadoshima, MD and Mituru Kinjo, MD Takahiro InoueTakahiro Inoue From the Division of Cardiology, Nippon Steel Yawata Memorial Hospital, Fukuoka, Japan. , Tokushi KogaTokushi Koga From the Division of Cardiology, Nippon Steel Yawata Memorial Hospital, Fukuoka, Japan. , Shigeru KasedaShigeru Kaseda From the Division of Cardiology, Nippon Steel Yawata Memorial Hospital, Fukuoka, Japan. , Yasuo KaizukaYasuo Kaizuka From the Division of Cardiology, Nippon Steel Yawata Memorial Hospital, Fukuoka, Japan. , Nobuyuki KawazoeNobuyuki Kawazoe From the Division of Cardiology, Nippon Steel Yawata Memorial Hospital, Fukuoka, Japan. , Seizo SadoshimaSeizo Sadoshima From the Division of Cardiology, Nippon Steel Yawata Memorial Hospital, Fukuoka, Japan. and Mituru KinjoMituru Kinjo From the Division of Cardiology, Nippon Steel Yawata Memorial Hospital, Fukuoka, Japan. Originally published5 Oct 2004https://doi.org/10.1161/01.CIR.0000143633.89691.95Circulation. 2004;110:e337–e338A 72-year-old man with chronic respiratory failure caused by pulmonary tuberculosis was admitted to our hospital for a sudden onset of severe back pain. He had often experienced a mild back pain of unknown origin during the last 5 months. Five months before admission, chest plain computed tomographic scan revealed no evidence of dissection or aneurysm in the thoracic aorta and demonstrated that a left-sided sharp calcified pleural edge was contacting vertically to the thoracic descending aorta (Figure 1A). Chest plain computed tomographic scan on admission revealed the calcified pleural edge perforating through the thoracic descending aorta and a massive thoracic hemorrhage (Figure 1B). Aortography showed no aneurysm or dissection in the aorta (Figure 2). He died 8 days after admission. Download figureDownload PowerPointFigure 1. A, Chest plain computed tomography 5 months before admission reveals no dissection or aneurysm in the thoracic descending aorta. There are calcified lesions on the posterior wall in the left pleura. The arrow indicates the sharp edge of the left-sided calcified pleura, which is vertically contacting the thoracic descending aorta. B, Chest plain computed tomography on admission shows the left hemothorax and the calcified pleural edge perforating through the whole layer of the left posterolateral aspect of the thoracic descending aorta (arrow).Download figureDownload PowerPointFigure 2. Aortography shows bleeding from the thoracic descending aorta to the left pleural space (between white arrows). It reveals no aneurysm or dissection in the aorta.At autopsy, the edge of the calcified pleural plaque across the perforation site of the aorta was very sharp. Histopathologically, no evidence of dissection, atheroma, abnormality of connective tissue, or inflammatory change was noted in the perforation site or other area of the aorta. Thus, we concluded that the calcified pleural edge incessantly pressed the aortic wall, resulting in the perforation into the thoracic aorta.FootnotesCorrespondence to Tokushi Koga, MD, Division of Cardiology, Nippon Steel Yawata Memorial Hospital, 1–1–1 Harunomachi, Yahatahigashi-ku, Kitakyusyu city, Fukuoka, 805–8508 Japan. E-mail [email protected] Previous Back to top Next FiguresReferencesRelatedDetailsCited ByRudolph T, Rudolph V, Edreira M, Cole M, Bonacci G, Schopfer F, Woodcock S, Franek A, Pekarova M, Khoo N, Hasty A, Baldus S and Freeman B (2010) Nitro–Fatty Acids Reduce Atherosclerosis in Apolipoprotein E–Deficient Mice, Arteriosclerosis, Thrombosis, and Vascular Biology, 30:5, (938-945), Online publication date: 1-May-2010.King A and Markus H (2009) Doppler Embolic Signals in Cerebrovascular Disease and Prediction of Stroke Risk, Stroke, 40:12, (3711-3717), Online publication date: 1-Dec-2009.Redgrave J, Gallagher P, Lovett J and Rothwell P (2008) Critical Cap Thickness and Rupture in Symptomatic Carotid Plaques, Stroke, 39:6, (1722-1729), Online publication date: 1-Jun-2008.Tuomainen A, Nyyssönen K, Laukkanen J, Tervahartiala T, Tuomainen T, Salonen J, Sorsa T and Pussinen P (2007) Serum Matrix Metalloproteinase-8 Concentrations Are Associated With Cardiovascular Outcome in Men, Arteriosclerosis, Thrombosis, and Vascular Biology, 27:12, (2722-2728), Online publication date: 1-Dec-2007.de Nooijer R, Verkleij C, von der Thüsen J, Jukema J, van der Wall E, van Berkel T, Baker A and Biessen E (2005) Lesional Overexpression of Matrix Metalloproteinase-9 Promotes Intraplaque Hemorrhage in Advanced Lesions But Not at Earlier Stages of Atherogenesis, Arteriosclerosis, Thrombosis, and Vascular Biology, 26:2, (340-346), Online publication date: 1-Feb-2006.Papaspyridonos M, Smith A, Burnand K, Taylor P, Padayachee S, Suckling K, James C, Greaves D and Patel L (2006) Novel Candidate Genes in Unstable Areas of Human Atherosclerotic Plaques, Arteriosclerosis, Thrombosis, and Vascular Biology, 26:8, (1837-1844), Online publication date: 1-Aug-2006.Sluijter J, Pulskens W, Schoneveld A, Velema E, Strijder C, Moll F, de Vries J, Verheijen J, Hanemaaijer R, de Kleijn D and Pasterkamp G (2005) Matrix Metalloproteinase 2 Is Associated With Stable and Matrix Metalloproteinases 8 and 9 With Vulnerable Carotid Atherosclerotic Lesions, Stroke, 37:1, (235-239), Online publication date: 1-Jan-2006.Galis Z (2004) Vulnerable Plaque, Circulation, 110:3, (244-246), Online publication date: 20-Jul-2004. October 5, 2004Vol 110, Issue 14 Advertisement Article InformationMetrics https://doi.org/10.1161/01.CIR.0000143633.89691.95PMID: 15466652 Originally publishedOctober 5, 2004 PDF download Advertisement SubjectsAngiographyComputerized Tomography (CT)