EURORAD ESR

Case 7820

Silent Emergency

Author(s)
Purvis JA, Hughes SM.
 
Patient
male, 70 year(s)
 
 
  • Figure 1
    Oblique multi-planar view of ascending aorta and left ventricle.

    Oblique MPR of ascending aorta (Ao) and left ventricle (LV). A large dissection sac is seen (hollow arrow) with clot inferiorly (*). This overlies the right coronary artery (RCA) but does not compromise it or the left...

     
     
     
  • Figure 2
    3D volumetric reconstruction (navigator view) of dissection extending into brachiocephalic trunk

    “Navigator” view from the aortic valve looking superiorly. The edges of the dissection flap (hollow arrows) ascend towards the orifice of the brachiocephalic trunk (BC). The left common carotid (LCC) and left...

     
     
     
  • Figure 3
    Oblique multi-planar view of dissection flap

    The dissection flap passes superiorly into the brachiocephalic trunk (white hollow arrow). The tear in the ascending aorta intima measures 4cm (red hollow arrow).

     
     
     
  • Figure 4
    Maximum intensity projection of right coronary and left circumflex arteries

    Right coronary artery (RCA) is ectatic and has non-obstructive calcific plaque. The left circumflex (LCx) appears satisfactory. Contrast is seen in the false lumen (*) with clot underneath. The RCA orifice is not...

     
     
     
  • Figure 5
    Maximum intensity projection of left coronary system

    False lumen (*) contains less contrast than true lumen. The left main stem is not compromised and divides into left anterior descending (LAD) and left circumflex (LCx) arteries

     
     
     
Oblique MPR of ascending aorta (Ao) and left ventricle (LV). A large dissection sac is seen (hollow arrow) with clot inferiorly (*). This overlies the right coronary artery (RCA) but does not compromise it or the left main stem artery (LMS).
 
“Navigator” view from the aortic valve looking superiorly. The edges of the dissection flap (hollow arrows) ascend towards the orifice of the brachiocephalic trunk (BC). The left common carotid (LCC) and left subclavian (LS) arteries are spared.
 
The dissection flap passes superiorly into the brachiocephalic trunk (white hollow arrow). The tear in the ascending aorta intima measures 4cm (red hollow arrow).
 
Right coronary artery (RCA) is ectatic and has non-obstructive calcific plaque. The left circumflex (LCx) appears satisfactory. Contrast is seen in the false lumen (*) with clot underneath. The RCA orifice is not compromised.
 
False lumen (*) contains less contrast than true lumen. The left main stem is not compromised and divides into left anterior descending (LAD) and left circumflex (LCx) arteries
 
 
 
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