title: Expanding pseudoaneurysm compressing the coronary arteries and causing cardiogenic shock.
abstract: A 37-year-old man who recently underwent aortic valve replacement after endocarditis presented with cardiogenic shock. A large expansile pseudoaneurysm was subsequently discovered using multiple imaging modalities. Although transesophageal echocardiography is important in diagnosing valve endocarditis, coronary CT angiography of prosthetic valves is feasible and image quality is good. In this case, coronary CT angiography allowed for better understanding of transesophageal echocardiography images and earlier diagnosis of coronary involvement as cause for left ventricular dysfunction.
authors.affiliation: Department of Internal Medicine, University of Iowa Hospital and Clinics, 200 Hawkins Drive, Iowa City, IA 52242, USA; Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA. Electronic address: seth-maliske@uiowa.edu.
authors.forename: Seth M
authors.initials: SM
authors.lastname: Maliske
authors.affiliation: Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: Laith
authors.initials: L
authors.lastname: Alshawabkeh
authors.affiliation: Department of Pathology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: Katie
authors.initials: K
authors.lastname: Schouweiler
authors.affiliation: Department of Internal Medicine, University of Iowa Carver College of Medicine, Iowa City, IA, USA; Department of Radiology, University of Iowa Carver College of Medicine, Iowa City, IA, USA.
authors.forename: Gardar
authors.initials: G
authors.lastname: Sigurdsson
mesh_terms: D000328:Adult; D017541:Aneurysm, False / Q000000981:diagnostic imaging / Q000209:etiology*; D001021:Aortic Valve / Q000000981:diagnostic imaging / Q000601:surgery*; D017023:Coronary Angiography / Q000379:methods; D023921:Coronary Stenosis / Q000000981:diagnostic imaging / Q000209:etiology*; D018618:Echocardiography, Doppler, Color; D017548:Echocardiography, Transesophageal; D006322:Heart Aneurysm / Q000000981:diagnostic imaging / Q000209:etiology*; D019918:Heart Valve Prosthesis Implantation / Q000009:adverse effects*; D006801:Humans; D008297:Male; D064847:Multimodal Imaging; D011237:Predictive Value of Tests; D012770:Shock, Cardiogenic / Q000175:diagnosis / Q000209:etiology* / Q000503:physiopathology; D014057:Tomography, X-Ray Computed; D018487:Ventricular Dysfunction, Left / Q000209:etiology
keywords: Cardiogenic shock; Coronary CT angiography; Infective endocarditis; Multimodality imaging; Pseudoaneurysm