title: Momentary and wide aortic regurgitation as an indicator of aortic dissection.
abstract: A 55-year-old female with a history of hypertension was admitted for dyspnea, epigastralgia and nausea. A chest X-ray showed pulmonary congestion. Transthoracic echocardiography (TTE) revealed severe left ventricular dysfunction with akinesis of the infero-posterior wall and Doppler color-flow mode showed mild aortic regurgitation (AR). Noninvasive positive pressure ventilation, intravenous heparin and diuretics were administered. Follow-up TTE revealed a dissection flap as well as momentary and wide AR only during isovolumetric relaxation. Contrast-enhanced computed tomography of the chest revealed Stanford type A aortic dissection. A momentary and wide AR in echocardiograms might serve as an important and useful indicator of aortic dissection in patients with acute myocardial infarction and congestive heart failure.
authors.affiliation: Division of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Inokuchi
authors.affiliation: Division of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan. osasaki@saitama-med.ac.jp.
authors.forename: Osamu
authors.initials: O
authors.lastname: Sasaki
authors.affiliation: Division of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
authors.forename: Toshihiko
authors.initials: T
authors.lastname: Nishioka
authors.affiliation: Division of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
authors.forename: Hiroyuki
authors.initials: H
authors.lastname: Ito
authors.affiliation: Division of Cardiology, Saitama Medical Center, Saitama Medical University, 1981 Kamoda, Kawagoe, Saitama, 350-8550, Japan.
authors.forename: Nobuo
authors.initials: N
authors.lastname: Yoshimoto
authors.affiliation: Division of Cardiovascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yamabi
authors.affiliation: Division of Cardiovascular Surgery, Saitama Medical Center, Saitama Medical University, Kawagoe, Japan.
authors.forename: Kazuhito
authors.initials: K
authors.lastname: Imanaka
authors.affiliation: Division of Cardiovascular Surgery, Ehime Prefectural Central Hospital, Matsuyama, Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Sasaki
mesh_terms: D000784:Aortic Dissection / Q000150:complications* / Q000175:diagnosis; D017545:Aortic Aneurysm, Thoracic / Q000150:complications* / Q000175:diagnosis; D001022:Aortic Valve Insufficiency / Q000175:diagnosis / Q000209:etiology*; D003937:Diagnosis, Differential; D004452:Echocardiography; D005260:Female; D006801:Humans; D008875:Middle Aged
keywords: Acute myocardial infarction; Aortic dissection; Aortic regurgitation; Congestive heart failure; Dissectional flap