Aortitis Masquerading as Intramural Hematoma: When to Observe, When to
Operate? A Case Report
- Ana Velez,
- Eric Etchill,
- Marc Halushka,
- Stefano Schena
Marc Halushka
Johns Hopkins University School of Medicine
Author ProfileStefano Schena
Johns Hopkins University School of Medicine
Author ProfileAbstract
Radiologic evidence of aortic disease is not always consistent with the
diagnosis. With lack of accompanying symptoms or with an atypical
presentation, diagnosis of aortic pathology relies greatly on imaging
techniques. We report the case of a 58 year-old female who presented
with incidental radiographic findings consistent with a type A aortic
intramural hematoma and a vague left-sided chest discomfort. After
follow-up imaging was consistent with disease progression and hematoma
expansion, the affected segment was resected and pathology reported
lymphoplasmacytic aortitis as the underlying etiology of the imaging
findings rather than an intramural hematoma. The patient lacked symptoms
or serology consistent with rheumatologic disease and the postoperative
course was uneventful. The management of a suspected ascending
intramural hematoma is controversial, especially when the patient
presents with atypical signs and symptoms. Features of disease
progression may warrant urgent surgical intervention.19 Oct 2020Submitted to Journal of Cardiac Surgery 21 Oct 2020Submission Checks Completed
21 Oct 2020Assigned to Editor
09 Dec 2020Reviewer(s) Assigned
21 Dec 2020Review(s) Completed, Editorial Evaluation Pending
22 Dec 2020Editorial Decision: Revise Minor
07 Jan 20211st Revision Received
07 Jan 2021Submission Checks Completed
07 Jan 2021Assigned to Editor
07 Jan 2021Reviewer(s) Assigned
08 Jan 2021Review(s) Completed, Editorial Evaluation Pending
08 Jan 2021Editorial Decision: Accept