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An Uncommon Complication of Nondissected Ascending Aortic Aneurysm

2005; Lippincott Williams & Wilkins; Volume: 112; Issue: 9 Linguagem: Inglês

10.1161/circulationaha.104.483495

1524-4539

Enrique Antón, Mariam Echeverría,

Infectious Aortic and Vascular Conditions

HomeCirculationVol. 112, No. 9An Uncommon Complication of Nondissected Ascending Aortic Aneurysm Free AccessReview ArticlePDF/EPUBAboutView PDFView EPUBSections ToolsAdd to favoritesDownload citationsTrack citationsPermissions ShareShare onFacebookTwitterLinked InMendeleyReddit Jump toFree AccessReview ArticlePDF/EPUBAn Uncommon Complication of Nondissected Ascending Aortic Aneurysm Enrique Antón and Mariam Echeverría Enrique AntónEnrique Antón From the Departments of Internal Medicine (E.A.) and Radiology (M.E.), Hospital of Zumárraga, Guipúzcoa, Spain. and Mariam EcheverríaMariam Echeverría From the Departments of Internal Medicine (E.A.) and Radiology (M.E.), Hospital of Zumárraga, Guipúzcoa, Spain. Originally published30 Aug 2005https://doi.org/10.1161/CIRCULATIONAHA.104.483495Circulation. 2005;112:e116–e117An 86-year-old woman was admitted with a 2-week-long history of increasing dyspnea. She had an ascending thoracic aortic aneurysm (8×9 cm) diagnosed 5 years before. On admission, the patient was in moderate respiratory distress. Her vital signs were blood pressure 130/80, heart rate 72 bpm (irregular), respiration rate 32 rpm, and temperature 36°C. Chest auscultation revealed decreased breath sounds at right base. The ECG showed atrial fibrillation. Basic laboratory data were unremarkable. Chest x-ray findings are shown in Figure 1. The echocardiogram revealed a nonenlarged left ventricle. Thoracocentesis yielded a pleural fluid with characteristics of transsudate. A thoracic CT scan confirmed that aortic aneurysm had been enlarged (9.5×10 cm), extended posteriorly, and severely compressed the right pulmonary vessels and left atrium, causing a massive right pleural effusion and pulmonary collapse without dissection, rupture, or pericardial effusion (Figures 2 and 3). The treatment was conservative because of the high risk involved. Download figureDownload PowerPointFigure 1. Chest x-ray showing mediastinal enlargement with large right pleural effusion.Download figureDownload PowerPointFigure 2. CT chest scan showing large ascending aortic aneurysm (9.5×10 cm) causing massive right pleural effusion and pulmonary collapse.Download figureDownload PowerPointFigure 3. CT chest scan (sagittal image) showing large aneurysmatic dilation of ascending aorta, especially at the level of the root and next portion.Thoracic aortic aneurysms enlarging as mediastinal masses are associated by compression or by rupture with a number of ischemic and mechanical complications. A large midline aneurysm of the ascending aorta may compress the pulmonary vessels, usually causing pulmonary venous hypertension and pulmonary edema. This patient represents an extremely unusual case of unilateral transudative pleural effusion caused by compression of pulmonary vessels by a large, nondissected aneurysm of the ascending aorta.FootnotesCorrespondence to Enrique Antón, MD, PhD, C/Eriete, 12 31180-Zizur Mayor, Navarra, Spain. E-mail [email protected] eLetters(0)eLetters should relate to an article recently published in the journal and are not a forum for providing unpublished data. Comments are reviewed for appropriate use of tone and language. Comments are not peer-reviewed. Acceptable comments are posted to the journal website only. Comments are not published in an issue and are not indexed in PubMed. Comments should be no longer than 500 words and will only be posted online. References are limited to 10. Authors of the article cited in the comment will be invited to reply, as appropriate.Comments and feedback on AHA/ASA Scientific Statements and Guidelines should be directed to the AHA/ASA Manuscript Oversight Committee via its Correspondence page.Sign In to Submit a Response to This Article Previous Back to top Next FiguresReferencesRelatedDetailsCited By Jorge A, Martins W, Moutinho V, Rezende J, Alves P, Villacorta H, Silveira P and Couto A (2018) Left atrium and pulmonary artery compression due to aortic aneurysm causing heart failure symptoms, Revista Portuguesa de Cardiologia (English Edition), 10.1016/j.repce.2017.04.013, 37:6, (539.e1-539.e3), Online publication date: 1-Jun-2018. Jorge A, Martins W, Moutinho V, Rezende J, Alves P, Villacorta H, Silveira P and Couto A (2018) Left atrium and pulmonary artery compression due to aortic aneurysm causing heart failure symptoms, Revista Portuguesa de Cardiologia, 10.1016/j.repc.2017.04.008, 37:6, (539.e1-539.e2), Online publication date: 1-Jun-2018. Huang J and Huang C (2013) Unexpected intraoperative desaturation and lobar atelectasis due to left bronchial occlusion by concealed ascending aortic aneurysm, Acta Anaesthesiologica Taiwanica, 10.1016/j.aat.2013.03.012, 51:1, (40-43), Online publication date: 1-Mar-2013. Walpot J, Amsel B, Pasteuning W and Olree M (2007) Left Atrial Compression by Dissecting Aneurysm of the Ascending Aorta, Journal of the American Society of Echocardiography, 10.1016/j.echo.2007.02.014, 20:10, (1220.e4-1220.e6), Online publication date: 1-Oct-2007. August 30, 2005Vol 112, Issue 9 Advertisement Article InformationMetrics https://doi.org/10.1161/CIRCULATIONAHA.104.483495PMID: 16129804 Originally publishedAugust 30, 2005 PDF download Advertisement SubjectsComputerized Tomography (CT)