Document Detail

Aortic intramural hemorrhage visualized by transesophageal echocardiography: findings and prognostic implications.
MedLine Citation:
PMID:  8113549     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: This study describes the transesophageal echocardiographic and follow-up findings in patients with aortic intramural hemorrhage. BACKGROUND: Localized aortic intramural hemorrhage resulting in layered thickening of the aortic wall seems to represent a variant of acute aortic dissection without communication or a typical moving intimal flap. In autopsy studies this variant, attributed to a rupture of the vasa vasorum, has been described in 5% to 10% of patients with dissection. METHODS: In a prospective transesophageal echocardiographic study in patients with aortic dissection performed between 1986 and 1991, the diagnosis of intramural hemorrhage was established in 15 of 114 patients and either confirmed anatomically (7 patients) with an additional diagnostic imaging technique or on the basis of clear follow-up changes (8 patients). RESULTS: Elderly patients (mean age 70 years) with a history of hypertension were affected by this variant of dissection. The ascending aorta was involved in 3 patients and the descending aorta in 12. The longitudinal extent varied between 3 and 20 cm, and wall thickness varied between 0.7 and 3 cm. Classic aortic dissection developed in five patients (33%) and rupture in four (27%). Regression of aortic wall thickening was noted in two patients, whereas three patients became asymptomatic without apparent wall changes (33%). Surgery was performed in 5 patients, whereas medical therapy was continued in 10. During a mean follow-up period of 11 months, eight patients (53%) died because of complications of the aortic disease. CONCLUSIONS: Intramural hemorrhage represents a variant of aortic dissection and may be an early finding in patients who develop classic aortic dissection or rupture. Transesophageal echocardiography is an excellent method for the detection of intramural hemorrhage and for monitoring these patients.
S Mohr-Kahaly; R Erbel; P Kearney; M Puth; J Meyer
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  23     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1994 Mar 
Date Detail:
Created Date:  1994-03-31     Completed Date:  1994-03-31     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  658-64     Citation Subset:  AIM; IM    
II. Medical Clinic, Johannes Gutenberg University Mainz, Germany.
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MeSH Terms
Aneurysm, Dissecting / epidemiology,  ultrasonography*
Aorta / ultrasonography
Aorta, Thoracic / ultrasonography
Aortic Aneurysm / epidemiology,  ultrasonography*
Aortic Aneurysm, Thoracic / epidemiology,  ultrasonography*
Aortic Rupture / epidemiology
Echocardiography, Transesophageal*
Follow-Up Studies
Prospective Studies
Time Factors

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