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intramural aortic hematoma
Classification:
- A type: involve the ascending aorta or aortic arch
- B type: begin distal to the left subclavian artery
Clinical manifestations:
- chest pain
- hypertension
Laboratory:
- plasma D-dimer may be elevated
Radiology:
- contrast CT of thorax
- seen as circuferential soft tissue density without contrast enhancement
Complications:
- malperfusion syndromes
Differential diagnosis:
- thoracic aortic aneurysm
Management:
- type A: emergency surgery
- type B:
- intravenous beta-blocker & nitroprusside as needed for blood pressure control
- surgery for malperfusion or significant aneurysmal dilatation
General
hematoma
vascular disease (vasculopathy)
References
- Medical Knowledge Self Assessment Program (MKSAP) 16,
American College of Physicians, Philadelphia 2012