1. Transverse Pericardial Sinus Hematoma From Type A Aortic Dissection: A Diagnostic Challenge
- Author
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Kyle Lehenbauer, Robert Tanenbaum, Laith Derbas, Raed Qarajeh, and Ahmed Elkaryoni
- Subjects
transverse pericardial sinus ,medicine.medical_specialty ,Perforation (oil well) ,Cardiology ,030204 cardiovascular system & hematology ,Transesophageal echocardiogram ,Chest pain ,03 medical and health sciences ,0302 clinical medicine ,Hematoma ,medicine.artery ,Ascending aorta ,medicine ,cardiovascular diseases ,pericardial hematoma ,Acute aortic syndrome ,Aortic dissection ,acute aortic dissection ,medicine.diagnostic_test ,business.industry ,General Engineering ,type a aortic dissection ,medicine.disease ,acute aortic syndrome ,cardiovascular system ,Radiology ,medicine.symptom ,Transthoracic echocardiogram ,business ,030217 neurology & neurosurgery - Abstract
Ascending (type A) aortic dissection can rarely result in contained transverse pericardial sinus hematoma that compresses adjacent structures making diagnosis more challenging. We present a rare case of a 77-year-old man who presented with sudden-onset chest pain and was admitted for a presumed acute coronary syndrome. Coronary angiography did not show significant stenosis and ruled out acute coronary syndrome. Transthoracic echocardiogram showed extracardiac structure compressing on the left atrium; hence, we performed transesophageal echocardiogram which confirmed aortic dissection and revealed a hematoma in the transverse pericardial sinus. Intraoperatively, a large hematoma in the transverse pericardial sinus was extracted and revealed a posterior perforation of the ascending aorta that extended into the left atrium.
- Published
- 2020