Aortic dissection with fistula to right atrium. Noninvasive diagnosis by two-dimensional and Doppler echocardiography with successful repair. Case report and review of the literature.
Aortic dissection with rupture into the right atrium is rare, and a high index of suspicion is required for its clinical recognition. The diagnosis should be considered in a patient with chest pain or dyspnea who at presentation has a widened pulse pressure, a continuous murmur, and evidence of right ventricular volume overload, especially when there is a history of a previous cardiac operation. Two-dimensional and Doppler echocardiography can establish the diagnosis and permit early surgical repair of the dissection and fistula.
D000368:Aged; D000784:Aortic Dissection / Q000175:diagnosis* / Q000601:surgery; D001014:Aortic Aneurysm / Q000175:diagnosis* / Q000601:surgery; D006328:Cardiac Catheterization; D004452:Echocardiography / Q000379:methods*; D005402:Fistula / Q000175:diagnosis* / Q000601:surgery; D006325:Heart Atria; D006331:Heart Diseases / Q000175:diagnosis* / Q000601:surgery; D006801:Humans; D008297:Male; D012422:Rupture, Spontaneous