A
77 year old woman was admitted to the emergency department with complaints of
intermittent cough, and sudden dyspnea since 5 days. There was no past history
of hypertension and cardiac symptoms. There was no significant family history. On
physical examination, the patient was dyspneic with cyanotic extremities, herroom air saturation was 90%, her heart rate was 96 beats per minute, and her
blood pressure was 130/90 mm Hg. Chest auscultation found a precordial murmur.
Chest
X ray revealed a mediastinal widening and cardiomegaly. The electrocardiogram
noted atrial fibrillation. Trans-thoracic echocardiography revealed a severely
dilated ascending aorta, and compressing the heart with grade 3 aortic
insufficiency, and normal left ventricular function. A thoraco-abdominal
computed tomography scan was performed. It showed a huge aneurysm of the aortic
root and involving the ascending aorta with the maximal diameter of 13.97 cm,
intraluminal thrombus, compressing the trachea, with no visible intimal tear. Biological
investigations showed no abnormalities. Because
of the huge diameter of the aneurysm and the compression of the trachea, we
decided to perform emergent surgical repair without doing a coronary
angiography. Read more>>>>>>>>>>>>>>>>>>>
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