Document Detail

Case report: aortic dissection and cystic medial degeneration in a 24-year-old without Marfan syndrome.
MedLine Citation:
PMID:  15678249     Owner:  NLM     Status:  MEDLINE    
The effective management of aortic dissection relies heavily on a high index of suspicion followed by timely definitive diagnosis. Young adults without a history of blunt trauma who are not at risk for atherosclerotic disease may lower this suspicion. We present a 24-year-old patient with complaints of chest pain who presented in multiple urgent care clinics and emergency departments. With a normal chest radiograph, he was repeatedly discharged home on analgesics until a loud murmur was heard. An echocardiogram revealed a dilated aortic root with an intimal flap consistent with a type II dissection. After surgical aortic repair with a Bentall procedure, he was discharged with complete relief of symptoms. Histologic reports revealed cystic medial degeneration. Physical examinations did not demonstrate the phenotypic manifestations of Marfan syndrome. This case illustrates the importance of cardiac auscultation when assessing an individual with chest pain, even with a low likelihood for alteration in arterial structure, and the maintenance of a high index of clinical suspicion despite a normal chest radiograph. We consider this case to be of interest because of its rarity in a 24-year-old.
Chris Caraang; Adel El-Bialy
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular pharmacology and therapeutics     Volume:  9     ISSN:  1074-2484     ISO Abbreviation:  J. Cardiovasc. Pharmacol. Ther.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2005-01-28     Completed Date:  2005-03-29     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9602617     Medline TA:  J Cardiovasc Pharmacol Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  299-302     Citation Subset:  IM    
Department of Cardiology, Olive View-UCLA Medical Center, UCLA School of Medicine, Sylmar, CA 91343, USA.
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MeSH Terms
Age Factors
Aneurysm, Dissecting / complications,  diagnosis*,  surgery
Aortic Aneurysm / complications,  diagnosis*,  surgery
Aortic Valve / pathology
Chest Pain / etiology
Diagnosis, Differential
Heart Murmurs / etiology
Radiography, Thoracic

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