Ultrasound has historically been limited to in-hospital use for the diagnosis and management of various conditions. However, with the advent of smaller and more portable devices, this technology can be used outside the hospital. This report describes a patient with chest pain and hypotension for whom a point-of-care cardiac ultrasound (POCUS) was performed to diagnose cardiac tamponade during critical care transport. She was subsequently found to have an acute type A aortic dissection, and her care was expedited to the operating room. Cardiac tamponade in the setting of acute type A aortic dissection requires urgent surgical repair; therefore, early diagnosis is crucial to survival. In this case, prehospital ultrasound facilitated rapid care for the patient. Further study is needed to define its role in the prehospital setting.
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http://dx.doi.org/10.1016/j.amj.2022.07.002 | DOI Listing |
Ann Transl Med
December 2024
Division of Cardiothoracic Surgery, Department of Surgery, The Chinese University of Hong Kong, Hong Kong, China.
Background And Objective: Patients with thoracic aortic aneurysm and dissection (TAAD) are often asymptomatic but present acutely with life threatening complications that necessitate emergency intervention. Aortic diameter measurement using computed tomography (CT) is considered the gold standard for diagnosis, surgical planning, and monitoring. However, manual measurement can create challenges in clinical workflows due to its time-consuming, labour-intensive nature and susceptibility to human error.
View Article and Find Full Text PDFJ Inflamm Res
January 2025
Department of Vascular Surgery, Nanjing Drum Tower Hospital, Affiliated Hospital of Medical School, Nanjing University, Nanjing, People's Republic of China.
Purpose: Stanford Type B Aortic Dissection (TBAD), a critical aortic disease, has exhibited stable mortality rates over the past decade. However, diagnostic approaches for TBAD during routine health check-ups are currently lacking. This study focused on developing a model to improve the diagnosis in a population.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
April 2025
Department of Surgery, University of Rochester School of Medicine, Rochester, NY.
Type B aortic dissection (TBAD) represents a serious medical emergency with up to a 50% associated 5-year mortality caused by thoracic aorta, dissection-associated aneurysmal (DAA) degeneration, and rupture. Unfortunately, conventional size-related diagnostic methods cannot distinguish high-risk DAAs that benefit from surgical intervention from stable DAAs. Our goal is to use DAA stiffness measured with magnetic resonance elastography (MRE) as a biomarker to distinguish high-risk DAAs from stable DAAs.
View Article and Find Full Text PDFJ Vasc Surg Cases Innov Tech
April 2025
Atrium Health, Sanger Heart and Vascular Institute, Division of Vascular Surgery, Charlotte, NC.
We report a case of mesenteric ischemia after thoracic endovascular aortic repair (TEVAR) for chronic type B aortic dissection performed at a different institution. Computed tomography angiography findings indicated that the previous TEVAR had been deployed distally into the false lumen. To mitigate this, a large fenestration was created between the false lumen and true lumen.
View Article and Find Full Text PDFHeliyon
July 2024
Department of Cardiovascular Surgery, First Affiliated Hospital of Nanjing Medical University, Nanjing, 210029, China.
Recent studies have attempted to characterize the layer-specific mechanical and microstructural properties of the aortic tissues in either normal or pathological state to understand its structural-mechanical property relationships. However, layer-specific tissue mechanics and compositions of normal and dissected ascending aortas have not been thoroughly compared with a statistical conclusion obtained. Eighteen ascending aortic specimens were harvested from 13 patients with type A aortic dissection and 5 donors without aortic diseases, with each specimen further excised to obtain three tissue samples including an intact wall, an intima-media layer and an adventitia layer.
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