RESUMO
Aortic dissection and rupture is a rare occurrence in pregnant and postpartum patients. This case discusses the presentation and diagnosis of a patient with an acute contained thoracic aortic aneurysm rupture at 38 weeks of gestation, after presenting with throat pain and syncope during the COVID-19 pandemic. The patient underwent emergent caesarean delivery for non-reassuring fetal heart tracing, following which continued syncope workup revealed an aortic aneurysm and pericardial effusion. Diagnosis in this case was finalised with multimodality imaging, including transthoracic echocardiogram, and the patient underwent surgical aortic repair.
Assuntos
Aneurisma da Aorta Torácica/virologia , Dissecção Aórtica/virologia , Ruptura Aórtica/virologia , Infecções por Coronavirus/complicações , Pneumonia Viral/complicações , Complicações Infecciosas na Gravidez/virologia , Adulto , COVID-19 , Feminino , Humanos , Pandemias , GravidezRESUMO
The aim of this report is to discuss emergent repair for complex aortic diseases in patients affected by novel coronavirus pneumonia (coronavirus disease-2019 [COVID-19]), describing a case of ruptured pararenal aortic aneurysm. An eighty-year-old man with COVID-19 was admitted for ruptured aneurysm of the pararenal aorta and hemorrhagic shock. Endovascular repair was chosen, and a proximal extension of the previous abdominal endograft was performed with parallel stents in the right renal artery and the superior mesenteric artery. Endovascular treatment and early anticoagulation are the key for success for vascular emergencies in patients with COVID-19, despite the risk of late endoleak.
Assuntos
Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/cirurgia , Betacoronavirus , Infecções por Coronavirus/complicações , Procedimentos Endovasculares , Pneumonia Viral/complicações , Idoso de 80 Anos ou mais , Aneurisma da Aorta Abdominal/virologia , Ruptura Aórtica/virologia , COVID-19 , Humanos , Masculino , Pandemias , SARS-CoV-2Assuntos
Ruptura Aórtica/virologia , Aortite/virologia , Infecções por HIV/virologia , Idoso , Terapia Antirretroviral de Alta Atividade , Ruptura Aórtica/diagnóstico , Ruptura Aórtica/cirurgia , Aortite/diagnóstico , Aortite/cirurgia , Aortografia/métodos , Implante de Prótese Vascular , Procedimentos Endovasculares , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Ruptura Espontânea , Tomografia Computadorizada por Raios X , Resultado do TratamentoRESUMO
Human immunodeficiency virus (HIV) infection has an impact on all systems of the body, including the cardiovascular system. A 54-year-old man presented with abdominal pain. Enhanced computed tomography revealed rupture of a pseudoaneurysm of the abdominal aorta. After surgery, the patient tested positive for HIV. Histological examination of the resected aorta showed leukocytoclastic vasculitis, a characteristic feature of HIV-related vasculitis.
Assuntos
Falso Aneurisma/virologia , Aneurisma da Aorta Abdominal/virologia , Ruptura Aórtica/virologia , Infecções por HIV/complicações , Vasculite Leucocitoclástica Cutânea/virologia , Dor Abdominal/virologia , Falso Aneurisma/diagnóstico por imagem , Falso Aneurisma/cirurgia , Terapia Antirretroviral de Alta Atividade , Aneurisma da Aorta Abdominal/diagnóstico por imagem , Aneurisma da Aorta Abdominal/cirurgia , Ruptura Aórtica/diagnóstico por imagem , Ruptura Aórtica/cirurgia , Aortografia/métodos , Biópsia , Implante de Prótese Vascular , Infecções por HIV/diagnóstico , Infecções por HIV/tratamento farmacológico , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada por Raios X , Resultado do Tratamento , Vasculite Leucocitoclástica Cutânea/diagnóstico por imagem , Vasculite Leucocitoclástica Cutânea/cirurgiaRESUMO
Cytomegalovirus (CMV) has been implicated in the pathogenesis of atherosclerosis. Abdominal aortic aneurysm is regarded traditionally as a consequence of atherosclerosis. Several microorganisms have been suggested as possible contributing factors for the development of abdominal aortic aneurysm. The relevance of CMV in the processes underlying the development, expansion, and rupture of abdominal aortic aneurysm is unknown. The aim of the present study was to investigate whether CMV infection is related to abdominal aortic aneurysm rupture. One hundred nineteen patients with abdominal aortic aneurysm and 36 matched controls without abdominal aortic aneurysm were investigated prospectively by CMV serology. Patients with ruptured abdominal aortic aneurysm have similar levels of IgG antibodies against CMV as patients with nonruptured abdominal aortic aneurysm, small abdominal aortic aneurysm, and controls without abdominal aortic aneurysm. In conclusion, this study fails to demonstrate a connection between CMV infection and abdominal aortic aneurysm rupture.
Assuntos
Aneurisma da Aorta Abdominal/virologia , Ruptura Aórtica/virologia , Aterosclerose/complicações , Infecções por Citomegalovirus/complicações , Idoso , Anticorpos Antivirais/sangue , Feminino , Humanos , Imunoglobulina G/sangue , Masculino , Estudos ProspectivosRESUMO
A woman with peripheral vascular disease developed cytomegalovirus colitis following repair of abdominal aortic aneurysm. Cytomegalovirus colitis developing in an immunocompetent individual may be caused by a breach in the integrity of the mucosal lining of the colon from various causes and should alert the clinician to explore these causes in order to provide effective care.