Date of Presentation

5-6-2021 12:00 AM

College

School of Osteopathic Medicine

Poster Abstract

There has been a significant increase in the incidence of thoracic aortic aneurysms, currently making aneurysmal disease the 18th most common cause of death within the United States. This disease is typically an insidious one, with the aorta growing an average of only 0.1 cm per year. Consequently, most patients remain asymptomatic until late stages of the disease when dissection or worse, rupture has occurred. Under extremely rare circumstances, thoracic aortic aneurysms can present clinically due to mass effect. Airway, esophageal and vascular compression, secondary to aortic arch dilation has been previously documented. The condition can be acquired or congenital, and can also manifest as double aortic arch, aberrant subclavian artery, and pulmonary artery sling. Additionally, Kommerell’s diverticulum, a bulbous configuration at the proximal descending aorta of left or right arch configuration, is a rare cause of tracheobronchial compression. Regardless of its form, mass effect due to thoracic vascular abnormality such as aneurysm can lead to tracheomalacia, and ultimately airway collapse, under chronic conditions. Clinical presentation can vary from cough, to hoarseness of voice, chest pain, and in the case of our patient, progressive dyspnea which was initially mistaken for acute exacerbation of chronic heart failure.

Keywords

aortic aneurysm, heart failure, case report

Disciplines

Cardiology | Cardiovascular Diseases | Cardiovascular System | Medicine and Health Sciences

Document Type

Poster

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May 6th, 12:00 AM

An Unusual ED Case: Aortic Aneurysm Presenting as CHF Exacerbation

There has been a significant increase in the incidence of thoracic aortic aneurysms, currently making aneurysmal disease the 18th most common cause of death within the United States. This disease is typically an insidious one, with the aorta growing an average of only 0.1 cm per year. Consequently, most patients remain asymptomatic until late stages of the disease when dissection or worse, rupture has occurred. Under extremely rare circumstances, thoracic aortic aneurysms can present clinically due to mass effect. Airway, esophageal and vascular compression, secondary to aortic arch dilation has been previously documented. The condition can be acquired or congenital, and can also manifest as double aortic arch, aberrant subclavian artery, and pulmonary artery sling. Additionally, Kommerell’s diverticulum, a bulbous configuration at the proximal descending aorta of left or right arch configuration, is a rare cause of tracheobronchial compression. Regardless of its form, mass effect due to thoracic vascular abnormality such as aneurysm can lead to tracheomalacia, and ultimately airway collapse, under chronic conditions. Clinical presentation can vary from cough, to hoarseness of voice, chest pain, and in the case of our patient, progressive dyspnea which was initially mistaken for acute exacerbation of chronic heart failure.

 

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