Ruptured aortic dissection into the left atrium which presented as congestive heart failure and was diagnosed by transoesophageal echocardiography.
A 72 year old man was admitted with severe dyspnoea. Ten days before he had had intense thoracic pain with loss of consciousness that was followed by increased dyspnoea. A continuous murmur was heard in the precordial and the left infrascapular regions. Lung auscultation showed stasis over the lower half of both lungs. Transthoracic echocardiography showed a bicuspid aortic valve and a dissection of the proximal aorta, which was considerably enlarged. Transoesophageal echocardiography confirmed dissection of the proximal aorta and showed a communication from the false lumen of the aortic dissection to the left atrium; and colour flow Doppler showed a continuous shunt to the left atrium. After transoesophageal echocardiography the patient had emergency surgical repair, which was successful. He had no complications in the post-operative period.
Van Camp
G
G
Department of Cardiology, St Pierre University Hospital, Brussels, Belgium.
Liebens
I
I
Silance
P G
PG
Cham
B
B
Vandenbossche
J L
JL
D000368:Aged; D000784:Aortic Dissection / Q000150:complications / Q000000981:diagnostic imaging*; D001019:Aortic Rupture / Q000150:complications / Q000000981:diagnostic imaging*; D017548:Echocardiography, Transesophageal; D006333:Heart Failure / Q000000981:diagnostic imaging / Q000209:etiology*; D006801:Humans; D008297:Male