Heart Views

A PICTURE IS WORTH A THOUSAND WORDS
Year
: 2018  |  Volume : 19  |  Issue : 3  |  Page : 114--115

Real-time imaging of aortic root rupture and cardiac tamponade in acute aortic dissection


Tomas Francisco Cianciulli1, María Cristina Saccheri2, Sergio Daniel Llanos Dethinne2, Carlos Manuel Barrero2, Víctor Miguel Mauro2,  
1 Researcher of the Ministry of Health, Government of the City of Buenos Aires; Department of Cardiology, Clínica Bazterrica, Buenos Aires, Argentina
2 Researcher of the Ministry of Health, Government of the City of Buenos Aires, Buenos Aires, Argentina

Correspondence Address:
Dr. Tomas Francisco Cianciulli
Clínica Bazterrica. Juncal 3002 (A1425AYL), Capital Federal, Buenos Aires
Argentina




How to cite this article:
Cianciulli TF, Saccheri MC, Llanos Dethinne SD, Barrero CM, Mauro VM. Real-time imaging of aortic root rupture and cardiac tamponade in acute aortic dissection.Heart Views 2018;19:114-115


How to cite this URL:
Cianciulli TF, Saccheri MC, Llanos Dethinne SD, Barrero CM, Mauro VM. Real-time imaging of aortic root rupture and cardiac tamponade in acute aortic dissection. Heart Views [serial online] 2018 [cited 2020 Oct 23 ];19:114-115
Available from: https://www.heartviews.org/text.asp?2018/19/3/114/254350


Full Text



A 62-year-old man was hospitalized in our emergency room because of chest pain. He had a history of severe aortic regurgitation due to Marfan syndrome. The patient underwent aortic valve replacement with a bileaflet prosthetic aortic valve.

On admission, a transthoracic echocardiography (TTE) showed Type A acute aortic dissection without pericardial effusion [Figure 1]a. Suddenly bubbles appeared inside the anterior pericardial sac due to bleeding of an acute rupture of the aortic root [Figure 1]b. There was mild pericardia effusion but this progressed rapidly to massive pericardial effusion [Figure 1]c and finally cardiac tamponade and death [[Figure 1]d and Video 1].{Figure 1}

[MULTIMEDIA:1]

According to the TTE timer, the whole sequence from mild pericardial effusion to cardiac tamponade and cardiac arrest occurred in < 29 s. Any resuscitation effort made (including urgent pericardiocentesis) to save the patient's life was ineffective.

To our knowledge, this is the first case reported in the literature of cardiac tamponade in acute aortic dissection with real-time imaging. The images were suboptimal but it is a rare glimpse into how patients die with type A aortic dissection. The presence of cardiac tamponade should prompt urgent aortic repair, as the mortality is very high (1% per hour during the first 48 hours, if untreated).

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.