ABSTRACT
Resumen: Los aneurismas de seno de Valsalva son una malformación rara de observar en la práctica clínica. Se presentan a cualquier edad y pueden ser de origen congénito o adquirido. La importancia de su estudio radica en que potencialmente pueden complicarse con rotura y fistulización a otra estructura cardíaca o extracardíaca, con una alta mortalidad asociada. El diagnóstico muchas veces puede ser complejo, pero existen algunos elementos clínicos inespecíficos que pueden orientarnos en su detección y rápido manejo, lo que puede marcar una diferencia en el pronóstico del paciente. Se presenta el caso de un paciente de 49 años con un aneurisma de seno de Valsalva complicado y a continuación una breve revisión del tema.
Abstract: Aneurysms of the sinus of Valsalva are. They occur at any age, either as a congenital or an acquired malformation. They may rupture and form a fístula to other cardiac structures, with a high mortality rate. The clinical case of a 49 year-old patient with a ruptured sinus of Valsalva an a fístula to the right atrium is presented. A brief review of the subject is included.
Subject(s)
Humans , Male , Middle Aged , Aortic Aneurysm/complications , Aortic Aneurysm/diagnostic imaging , Aortic Rupture/complications , Aortic Rupture/diagnostic imaging , Aortic Aneurysm/surgery , Aortic Rupture/surgery , Sinus of Valsalva/surgery , Sinus of Valsalva/diagnostic imaging , Tomography, X-Ray Computed , Echocardiography, TransesophagealABSTRACT
Abstract Takayasu's arteritis is a type of primary systemic vasculitis that affects medium and large arteries, including the aorta and its main branches, as well as the pulmonary and coronary arteries. Although rare in children, it is the third most common vasculitis in the pediatric population, often with delayed diagnosis due to the nonspecific presentation of clinical symptoms in its initial phase. This is a case of a 16-year-old girl with a giant ruptured abdominal aortic aneurysm, who needed surgery on an emergency basis. The etiological aspects involved in aneurysms in young patients are also addressed.
Subject(s)
Humans , Female , Adolescent , Aortic Rupture/surgery , Aortic Aneurysm, Abdominal/surgery , Takayasu Arteritis/complications , Aortic Rupture/diagnostic imaging , Retroperitoneal Space/diagnostic imaging , Aortic Aneurysm, Abdominal/etiology , Aortic Aneurysm, Abdominal/diagnostic imaging , Hematoma/diagnostic imaging , Hypertension/complicationsABSTRACT
Objetivo A síndrome de Terson (ST), também conhecida como hemorragia vítrea, é relatada em pacientes com hemorragia subaracnóide causada por um aneurisma rompido. Este estudo tem como objetivo avaliar a presença de hemorragia ocular nesses pacientes, buscando identificar aqueles que poderiam se beneficiar do tratamento específico para a recuperação do déficit visual. Métodos Estudo prospectivo de 53 pacientes com hemorragia subaracnóide espontânea (SSAH) por aneurisma rompido. Os pacientes foram avaliados quanto à hemorragia vítrea por fundoscopia indireta com 6 a 12 meses de seguimento. Resultados A idade dos pacientes variou de 17 a 79 anos (média de 45,9 ± 11,7); 39 pacientes eram do sexo feminino (73%) e 14 do sexo masculino (27%). Seis pacientes (11%) apresentaram ST e 83,3% apresentaram perda transitória de consciência durante a ictus. Conclusões Uma avaliação oftalmológica deve ser realizada rotineiramente em pacientes com hemorragia subaracnóide, especialmente naqueles com pior grau neurológico. Além disso, o prognóstico foi ruim em pacientes com ST.
Subject(s)
Humans , Male , Female , Aortic Rupture/diagnostic imaging , Subarachnoid Hemorrhage/diagnostic imaging , Vitreous Hemorrhage/diagnostic imaging , Retinal Hemorrhage/diagnostic imaging , Diagnostic Techniques, Ophthalmological , Aortic Rupture/mortality , Spinal Puncture/methods , Subarachnoid Hemorrhage/mortality , Vitrectomy/methods , Vitreous Hemorrhage/mortality , Retinal Hemorrhage/mortality , Cerebral Angiography/methods , Chi-Square Distribution , Prospective StudiesABSTRACT
Objective Terson syndrome (TS), also known as vitreous hemorrhage, is reported in patients with subarachnoid hemorrhage caused by a ruptured aneurysm. This study aims to evaluate the presence of ocular hemorrhage in such patients, trying to identify those who could benefit from the specific treatment for visual deficit recovery. Methods Prospective study of 53 patients with spontaneous subarachnoid hemorrhage (SSAH) due to ruptured aneurysm. The patients were evaluated for vitreous hemorrhage through indirect fundoscopy with 6 to 12 months of follow-up. Results The ages of the patients ranged from 17 to 79 years-old (mean age, 45.9 11.7); 39 patients were female (73%) and 14 were male (27%). Six patients (11%) presented TS, and 83.3% had a transient loss of consciousness during ictus. Conclusions An ophthalmologic evaluation must be routinely performed in subarachnoid hemorrhage patients, especially in those with worse neurological grade. Moreover, prognosis was bad in TS patients.
Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aortic Rupture/complications , Subarachnoid Hemorrhage/etiology , Vitreous Hemorrhage/mortality , Vitreous Hemorrhage/diagnostic imaging , Aortic Rupture/mortality , Aortic Rupture/diagnostic imaging , Prognosis , Subarachnoid Hemorrhage/mortality , Subarachnoid Hemorrhage/diagnostic imaging , Chi-Square Distribution , Data Interpretation, Statistical , Diagnostic Techniques, OphthalmologicalABSTRACT
Abstract: A young man presented to the emergency room with symptoms of recent onset heart failure. On physical examination he showed signs of right heart failure and a continuous murmur. Transesophageal echocardiography an computed tomography confirmed the diagnosis of a ruptured right sinus of Valsalva aneurysm an left to right shunt. After successful surgical repair the patient became asymptomatic, the shunt disappeared and he is well 3 months after surgery.
Resumen: Se presenta el caso clínico de un hombre joven que desarrolla insuficiencia cardíaca de reciente comienzo. Clínicamente lo relevante eran signos de insuficiencia cardíaca derecha y la presencia de un soplo continuo. Por ecocardiografía trans esofágica y Angio TAC, se confirmó la presencia de un aneurisma del seno de Valsalva derecho roto con cortocircuito de izquierda a derecha. Se procedió al cierre del aneurisma, confirmando se buen resultado, acompañado de una evolución asintomática 3 meses después de la intervención.
Subject(s)
Humans , Male , Adult , Aortic Rupture/complications , Heart Failure/etiology , Aortic Rupture/surgery , Aortic Rupture/diagnostic imaging , Sinus of Valsalva/surgery , Sinus of Valsalva/diagnostic imaging , Acute Disease , Echocardiography, TransesophagealABSTRACT
Intracranial aneurysm rupture causes subarachnoid hemorrhage in 80% of the cases, and it may be associated with intracerebral hemorrhage and/or intraventricular hemorrhage (IVH) in 34% and 17% of the patients, respectively. However, on rare occasions, aneurysm rupturemay be present causing isolate intracerebral hemorrhage or IVH without subarachnoid hemorrhage. We describe an unusual case of an anterior communicating aneurysm rupture presented with IVH, without subarachnoid hemorrhage. Although isolated IVH is rare, aneurysm rupture is a possible condition. Patients presenting with head computed tomography revealing IVH without subarachnoid hemorrhage should be promptly investigated with contrasted image exam to identify and treat possible causes, even in the absence of subarachnoid hemorrhage.
Subject(s)
Humans , Male , Aged , Aortic Rupture/complications , Aneurysm, Ruptured/surgery , Cerebral Intraventricular Hemorrhage/etiology , Cerebral Intraventricular Hemorrhage/diagnostic imaging , Aortic Rupture/diagnostic imaging , Subarachnoid Hemorrhage/epidemiology , Intracranial Aneurysm/complications , Computed Tomography Angiography/methodsABSTRACT
Extra-pulmonary diseases may mimic pulmonary lesions on chest radiography. We report a case of a silent rupture of an atherosclerotic thoracic aortic aneurysm with peripheral thrombus formation, that closely mimicked a complicated lung malignancy.
Subject(s)
Aortic Aneurysm/diagnosis , Aortic Aneurysm/diagnostic imaging , Aortic Rupture/diagnosis , Aortic Rupture/diagnostic imaging , Diagnosis, Differential , Humans , Lung Neoplasms/diagnosis , Lung Neoplasms/diagnostic imaging , Male , Middle Aged , Radiography, Thoracic , Tomography, X-Ray ComputedABSTRACT
Eighteen blunt chest trauma patients who had mediastinal widening on chest roengenogram were studied for the correlation with traumatic ruptured of the aorta or its major branches. Seventeen patients were male and one was female. The age ranged from 18 to 39 years, mean 26.17+/-6.85SD. The Injury Severity Score (ISS) ranged from 9 to 34, mean 25.5+/-6.49SD. Fourteen patients (77.8%) sustained motorcycle accidents, 3 patients (16.7%) sustained car accidents and 1 patient (5.5%) fell from a 4 storey building. All patients underwent aortography to search for traumatic rupture of the aorta or its major branches. Six patients had computed tomography of the chest before aortography. Nine patients (50%) had normal aortography. The remaining 9 patients who had positive aortography underwent urgent thoracotomies, 8 of them had traumatic rupture of the aorta or its major branches, the remaining 1 patient had normal operative finding. Of the 8 patients who had traumatic rupture of the aorta or its major branches, 1 patient died. The mortality was 12.5 per cent. The rate of traumatic rupture of the aorta or its major branches in patients who had blunt chest trauma and widening of the mediastinum on chest roengenogram in our study was 44.4 per cent. The sensitivity of aortography for diagnosis of traumatic rupture of the aorta or its major branches was 100 per cent and the specificity was 90 per cent. On the basis of this study, we conclude that blunt chest trauma patients with widened mediastinum on chest roengenogram have a significantly high rate of traumatic rupture of the aorta or its major branches. All blunt chest trauma patients who have widened mediastinum on chest reongenogram should undergo further investigations to exclude traumatic rupture of the aorta or its major branches. We recommend aortography as the investigation of choice due to its accuracy and usefulness in management plan.