Misdiagnosed Aortic Intramural Hematoma and the Role of Intravascular Ultrasound Imaging in Detection of Acute Aortic Syndrome: A Case Report

• Main Authors: Niya Mileva, MD, Dobrin Vassilev, MD, PhD, Robert Gil, MD, PhD, Gianluca Rigatelli, MD, PhD
• Format: Article
• Language: English
• Published: Compuscript 2018-01-01
• Series: Cardiovascular Innovations and Applications
• Subjects: acute aortic syndrome; aortic dissection; aortic intramural hematoma; penetrating atherosclerotic ulcer; intravascular ultrasound imaging
• Online Access: http://www.ingentaconnect.com/content/cscript/cvia/2018/00000002/00000004/art00008
• ISSN: 2009-8618; 2009-8782

Acute aortic syndrome includes classic aortic dissection, aortic intramural hematoma, and penetrating atherosclerotic ulcer – a group of conditions that are defined by their dynamic evolution and similar clinical manifestation. Accurate diagnosis and prompt treatment are essential as all the aforementioned conditions are a significant threat to a patient’s life. However, acute aortic syndrome and especially aortic intramural hematoma may be challenging diagnostic problems. Intravascular ultrasound imaging is a diagnostic method that can be useful for more thorough evaluation of the aortic lesion and can particularly aid in discerning the different forms of acute aortic syndrome. We present a case of a patient with aortic intramural hematoma that was missed by conventional imaging studies but was successfully visualized with intravascular ultrasound imaging.