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Aortic rupture is a rare, extremely dangerous condition that is considered a medical emergency. [1] The most common cause is an abdominal aortic aneurysm that has ruptured spontaneously. Aortic rupture is distinct from aortic dissection , which is a tear through the inner wall of the aorta that can block the flow of blood through the aorta to ...
The condition is difficult to detect and may go unnoticed, because many patients have no specific symptoms. Diagnosis is further complicated by the fact that many patients with the injury experienced multiple other serious injuries as well, [10] so the attention of hospital staff may be distracted from the possibility of aortic rupture. In fact ...
The condition can be mimicked by a ruptured cyst of the pericardium, [11] ruptured aortic aneurysm [10] and acute coronary syndrome. [12] Misdiagnosis is estimated at 39% and is associated with delays correct diagnosis and improper treatment with anticoagulants producing excessive bleeding and extended hospital stays. [12]
Therefore, aortic injury is on a scale from injury to a part of the inner layer to a complete tear of all three layers. [7] There are 4 grades of aortic injury. [1] Type I: Intimal tear; Type II: Intramural hematoma; Type III: Pseudoaneurysm; Type IV: Rupture; In addition to the 4 grades of aortic injury, the risk of rupture can also be ...
The initial tear is usually within 100 mm of the aortic valve, so a retrograde dissection can easily compromise the pericardium leading to a hemopericardium. Anterograde dissections may propagate all the way to the iliac bifurcation of the aorta, rupture the aortic wall, or recanalize into the intravascular lumen leading to a double-barrel aorta.
Aneurysms may affect the right (65–85%), non-coronary (10–30%), or rarely the left (< 5%) coronary sinus. [1] These aneurysms may not cause any symptoms but if large can cause shortness of breath, palpitations or blackouts. Aortic sinus aneurysms can burst or rupture into adjacent cardiac chambers, which can lead to heart failure if untreated.
Rupture may be the first sign of AAA. Once an aneurysm has ruptured, it presents with classic symptoms of abdominal pain which is severe, constant, and radiating to the back. [8] The diagnosis of an abdominal aortic aneurysm can be confirmed by the use of ultrasound. Rupture may be indicated by the presence of free fluid in the abdomen.
On a gross level, there is a pear-shaped, symmetric enlargement due to proximal aortic dilation. The aortic wall dilatation at the commissural level causes the cusps to effectively shorten and prevent them from converging during systole, which results in aortic valve incompetence. The arch is typically spared from the aneurysmal process, though ...
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