Aortic dissection in a young male with isolated interrupted aortic arch: an unusual association

Abstract

Interruption of the aortic arch (IAA) is a rare congenital anomaly which has been infrequently documented in the adult population. Aortic dissection (AD) is an emergency often presenting as acute chest pain and warranting urgent intervention. A 32-year-old male presented to Emergency Department with acute chest pain. Clinical examination revealed feeble pulses in bilateral lower limbs with a blood pressure difference between upper and lower limbs. Two-dimensional Echocardiography was suggestive of IAA with AD in the descending thoracic aorta. This was confirmed on computed tomography scan of the aorta which revealed complete interruption of the aortic arch distal to left subclavian artery along with the presence of an intimo-medial flap in descending thoracic aorta. A diagnosis of IAA with AD was made. The patient underwent an urgent aortic repair surgery following which he has been largely asymptomatic. A suspicion of AD should always be made in any patient presenting with acute onset chest pain radiating to the back along with accelerated hypertension/feeble pulses in extremity. Occurrence of AD in an adult with IAA is a distinct rarity and has been documented only thrice.

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References

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Three-dimensional reconstruction of the CT aortogram showing a short segment complete interruption of the aortic arch (white arrowhead) just distal to the origin of left sub-clavian artery along with the presence of a linear intimo-medial flap (white arrow) in the descending aorta distal to the interrupted segment
Published
2021-02-15
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Issue
Section
Cardiology - Case Reports
Keywords:
Aortic dissection, D-dimer, echocardiography, interrupted aortic arch, multi detector Computed Tomography
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How to Cite
Kunal, S., Pathak, P., Mittal, S., Pathak, V., & Vaswani, P. (2021). Aortic dissection in a young male with isolated interrupted aortic arch: an unusual association. Monaldi Archives for Chest Disease, 91(1). https://doi.org/10.4081/monaldi.2021.1404