Aortic dissection (AD) is a rare, time-sensitive, and potentially fatal condition that can present with subtle signs requiring timely diagnosis and intervention. Although definitive diagnosis is most accurately made through computed tomography angiography, this can be a time-consuming study and the patient may be unstable, thus preventing the study's completion. Chest radiography (CXR) signs of AD are classically taught yet have poor diagnostic reliability. Point-of-care ultrasound (POCUS) is increasingly used by emergency physicians for the rapid diagnosis of emergent conditions, with multiple case reports illustrating the sonographic signs of AD. We present a case of Stanford type B AD diagnosed by POCUS in the emergency department in a patient with vague symptoms, normal CXR, and without aorta dilation. A subsequent review of CXR versus sonographic signs of AD is described.
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http://dx.doi.org/10.5811/cpcem.2019.5.42928 | DOI Listing |
Cancers (Basel)
January 2025
Department of Clinical Oncology, Pamela Youde Nethersole Eastern Hospital, Hong Kong, China.
Approximately 36% of patients with cervical cancer present with regional nodal metastasis at diagnosis, which is associated with adverse survival outcomes after definitive treatment. In the modern era of chemoradiotherapy (CRT) and image-guided adaptive brachytherapy (IGABT), where excellent local control is achieved for patients with locally advanced cervical cancer (LACC), nodal failure remains a major challenge to cure. To optimize treatment outcomes for node-positive LACC and reduce the incidence of nodal failure, various treatment approaches have been explored, including methods of surgical nodal staging or dissection, RT dose escalation strategies, such as intensity-modulated radiotherapy (IMRT) with simultaneous integrated boost (SIB) to involved nodes, and elective treatment of subclinical para-aortic (PAO) disease.
View Article and Find Full Text PDFDiagnostics (Basel)
January 2025
Department of Cardiovascular Surgery, Faculty of Medicine, Atatürk University, Erzurum 25030, Türkiye.
Acute aortic syndrome (AAS) encompasses a range of life-threatening conditions, including classical dissection, intramural hematoma, and penetrating aortic ulcer. Each of these conditions presents distinct clinical characteristics and carries the potential to progress to rupture. Because AAS can be asymptomatic or present with diverse symptoms, its diagnosis requires clinical evaluation, risk scoring, and biomarkers such as D-dimer (DD), C-reactive protein (CRP), homocysteine, natriuretic peptides (BNP), and imaging modalities like computed tomography (CT), magnetic resonance imaging (MRI), and echocardiography.
View Article and Find Full Text PDFJ Cardiothorac Vasc Anesth
January 2025
Department of Anesthesiology, The Yangzhou Clinical Medical College of Xuzhou Medical University, Yangzhou, Jiangsu Province, China. Electronic address:
Objective(s): To investigate whether cerebral oximetry index (COx)-guided blood pressure management during cardiopulmonary bypass (CPB) could reduce postoperative delirium (POD) in patients undergoing acute type A aortic dissection (ATAAD) repair.
Design: A prospective, randomized controlled trial.
Setting: Patients undergoing ATAAD repair with CPB.
Eur Heart J Cardiovasc Pharmacother
January 2025
Department of vascular surgery, the Second Affiliated Hospital of Nanchang University, No. 1 Minde Road, Nanchang, Jiangxi, China, 330006.
Objective: To assess the impact of lipid-lowering drugs (LLDs) and antihypertensive drugs on the risk of aortic diseases.
Methods: Mendelian randomization was utilized to analyze data from 500,000 participants in the UK Biobank to evaluate the effects of statins, PCSK9 inhibitors (PCSK9i), beta-blockers, and calcium channel blockers on the risks of thoracic aortic aneurysm (TAA), abdominal aortic aneurysm (AAA), and aortic dissection (AD) using genetic variants as proxies. Real-world pharmacovigilance data from the FAERS database was used.
Ann Vasc Surg
January 2025
Division of Vascular Surgery and Endovascular Therapy, University of Florida, Gainesville, FL, USA.
The management of type B aortic dissection is one of the most challenging and debated topics in contemporary cardiovascular surgery practice. Patients with acute or chronic dissection-related complications, face high morbidity and mortality if not treated promptly. For most patients requiring intervention, thoracic endovascular aortic repair (TEVAR) is considered the gold standard.
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