title: Aortic intramural hematoma: an unpredictable evolution.
abstract: Aortic intramural hematoma (IMH) is an acute aortic syndrome characterized by bleeding into the media of the aortic wall without intimal disruption or the classic flap formation. Its natural history is variable and still poorly understood, so strategies for therapeutic management are not fully established. In some cases there is partial or complete regression of the hematoma under medical treatment, but most progress to dissection, aneurysmal dilatation or aortic rupture. The authors present the case of a 44-year-old hypertensive male patient admitted with a diagnosis of IMH of the descending aorta. Despite initial symptom resolution and optimal medical therapy, the IMH evolved to a pseudoaneurysm, which was successfully treated by an endovascular approach.
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Vila Nova Gaia/Espinho, Portugal. Electronic address: martacmponte@gmail.com.
authors.forename: Marta
authors.initials: M
authors.lastname: Ponte
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Vila Nova Gaia/Espinho, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Dias Ferreira
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Vila Nova Gaia/Espinho, Portugal.
authors.forename: Nuno
authors.initials: N
authors.lastname: Bettencourt
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Vila Nova Gaia/Espinho, Portugal.
authors.forename: Daniel
authors.initials: D
authors.lastname: Caeiro
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Vila Nova Gaia/Espinho, Portugal.
authors.forename: Marlene
authors.initials: M
authors.lastname: Fonseca
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Vila Nova Gaia/Espinho, Portugal.
authors.forename: Aníbal
authors.initials: A
authors.lastname: Albuquerque
authors.affiliation: Serviço de Cirurgia Cardiotorácica, Centro Hospitalar de Vila Nova Gaia/Espinho, Portugal.
authors.forename: Luís
authors.initials: L
authors.lastname: Vouga
authors.affiliation: Serviço de Cardiologia, Centro Hospitalar de Vila Nova Gaia/Espinho, Portugal.
authors.forename: Vasco
authors.initials: V
authors.lastname: Gama
mesh_terms: D000328:Adult; D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000175:diagnosis; D001019:Aortic Rupture / Q000150:complications* / Q000175:diagnosis; D006406:Hematoma / Q000150:complications* / Q000175:diagnosis; D006801:Humans; D008297:Male
keywords: Aorta torácica; Aortic dissection; Dissecção aórtica; Endovascular stent graft; Hematoma intramural; Intramural hematoma; Prótese endovascular; Thoracic aorta