title: Acute aortic syndrome mimicking intramural hematoma with hemopericardium.
abstract: We report a case of acute aortic syndrome in a 64-year-old man who presented with chest pain and hypotension. His electrocardiogram and cardiac troponins were normal. Computed tomography showed hemopericardium of 2.4 cm, but no aortic intimal tear. At surgery, the portion of the aorta affected by adventitial hemorrhage was replaced with a Dacron graft. A nonpenetrating ulcerated plaque was also observed. Massive bleeding through the chest drains with hypotension required emergency reoperation in the intensive care unit. The patient was discharged home on postoperative day 11.
authors.affiliation: Intensive Care Unit, University Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain rjararubio@yahoo.es.
authors.forename: Rubén
authors.initials: R
authors.lastname: Jara-Rubio
authors.affiliation: Intensive Care Unit, University Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Silvia
authors.initials: S
authors.lastname: Sánchez-Cámara
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Rubén
authors.initials: R
authors.lastname: Taboada-Martín
authors.affiliation: Department of Cardiovascular Surgery, University Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Antonio
authors.initials: A
authors.lastname: Jiménez-Aceituno
authors.affiliation: Intensive Care Unit, University Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Manuel
authors.initials: M
authors.lastname: García-Villa
authors.affiliation: Department of Pathology, University Hospital Virgen de la Arrixaca, El Palmar, Murcia, Spain.
authors.forename: Inmaculada
authors.initials: I
authors.lastname: Vidal-Abarca
mesh_terms: D000208:Acute Disease; D001018:Aortic Diseases / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D001706:Biopsy; D019917:Blood Vessel Prosthesis Implantation / Q000009:adverse effects; D002637:Chest Pain / Q000209:etiology; D003937:Diagnosis, Differential; D006406:Hematoma / Q000175:diagnosis*; D006470:Hemorrhage / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D007022:Hypotension / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D010490:Pericardial Effusion / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D019106:Postoperative Hemorrhage / Q000209:etiology / Q000503:physiopathology / Q000601:surgery; D011237:Predictive Value of Tests; D012086:Reoperation; D013577:Syndrome; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014456:Ulcer / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery
keywords: Aneurysm; aortic aneurysm; diagnosis; differential; dissecting; thoracic