title: Large thoracic aortic aneurysm and dissection with rare complication.
abstract: Thoracic aortic aneurysms can be found incidentally, however, patients can also present with acute dissection and or rupture that can be fatal. Symptoms that might indicate dissection include chest and back pain as well as lightheadedness. The diagnosis can be made with imaging studies such as computed tomography or magnetic resonance angiogram and sometimes transesophageal echocardiogram. Management is based on the aneurysmal size, location, extension, and the presence of complications. Although smaller localized and slow growing aneurysms can be monitored, larger and or complicated ones may warrant immediate repair. Less-common complications include compression over anatomic structures in the vicinity including vessels and the mediastinum. We report a unique case of a 71-year-old man who presented with a very large thoracic aortic aneurysm with dissection causing compression over the brachiocephalic veins and the mediastinum leading to facial and upper extremity swelling, dysphagia, and cough. This case represents a rare but significant complication of thoracic aortic aneurysm and emphasizes the challenges of its management.
authors: Vascular Medicine, Minneapolis Heart Institute, Minneapolis, MN. Electronic address: nedaa.skeik@allina.com.
authors: Nedaa
authors: N
authors: Skeik
authors: Minneapolis Heart Institute Research Foundation, Minneapolis, MN.
authors: Aisha K
authors: AK
authors: Ahmed
authors: Interventional Radiology, Abbott Northwestern Hospital, Minneapolis, MN.
authors: Clark W
authors: CW
authors: Schumacher
authors: Vascular Surgery, Minneapolis Heart Institute, Minneapolis, MN.
authors: Troy
authors: T
authors: Decker
authors: Vascular Surgery, Minneapolis Heart Institute, Minneapolis, MN.
authors: Timothy M
authors: TM
authors: Sullivan
mesh_terms: D000368:Aged; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology; D001027:Aortography / Q000379:methods; D016121:Brachiocephalic Veins / Q000000981:diagnostic imaging / Q000503:physiopathology; D003251:Constriction, Pathologic; D003371:Cough / Q000175:diagnosis / Q000209:etiology*; D003680:Deglutition Disorders / Q000175:diagnosis / Q000209:etiology*; D004487:Edema / Q000175:diagnosis / Q000209:etiology*; D005145:Face; D017809:Fatal Outcome; D006439:Hemodynamics; D006801:Humans; D018810:Magnetic Resonance Angiography; D008297:Male; D010690:Phlebography; D014057:Tomography, X-Ray Computed; D034941:Upper Extremity