title: Dissecting heart failure.
abstract: Dissection of ascending aorta is a medical emergency typically presenting with acute chest or back pain and hemodynamic instability. We are reporting a very unusual case of dissection of a large ascending aortic aneurysm presenting as a new onset heart failure. A 46-year-old man presented with gradually increasing dyspnea and orthopnea. His physical examination and laboratory findings were consistent with heart failure. The only unusual feature was a diastolic murmur, which prompted echocardiographic evaluation. Besides left ventricular dilatation, hypertrophy, and severe global hypokinesis, which were expected, we also found severely dilated aortic root with aortic regurgitation and a 8.6×9.7 cm ascending aortic aneurysm with dissection. The patient had a brother who died several years earlier from aortic dissection. Surgical treatment was successful. Type A aortic dissection may rarely present as heart failure. Aortic dissection at young age should prompt screening of first-degree relatives because genetic nature of the disease is very likely.
authors.affiliation: Department of Cardiology, University of South Florida, Tampa, FL 33618, USA.
authors.forename: Sameer
authors.initials: S
authors.lastname: Verma
authors.affiliation: Department of Cardiology, University of South Florida, Tampa, FL 33618, USA.
authors.forename: Sameer
authors.initials: S
authors.lastname: Gupta
authors.affiliation: Department of Cardiology, University of South Florida, Tampa, FL 33618, USA. Electronic address: mguglin@health.usf.edu.
authors.forename: Maya
authors.initials: M
authors.lastname: Guglin
mesh_terms: D000784:Aortic Dissection / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D001011:Aorta / Q000000981:diagnostic imaging; D001014:Aortic Aneurysm / Q000175:diagnosis / Q000000981:diagnostic imaging / Q000209:etiology*; D004452:Echocardiography; D004636:Emergency Service, Hospital; D006333:Heart Failure / Q000150:complications*; D006801:Humans; D008297:Male; D008875:Middle Aged