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The Journal of Thoracic and Cardiovascular Surgery, Vol 92, 953-957, Copyright © 1986 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Aortic dissection with fistula to right atrium. Noninvasive diagnosis by two-dimensional and Doppler echocardiography with successful repair. Case report and review of the literature

DV Hurley, RA Nishimura, HV Schaff and WD Edwards

Aortic dissection with rupture into the right atrium is rare, and a high index of suspicion is required for its clinical recognition. The diagnosis should be considered in a patient with chest pain or dyspnea who at presentation has a widened pulse pressure, a continuous murmur, and evidence of right ventricular volume overload, especially when there is a history of a previous cardiac operation. Two-dimensional and Doppler echocardiography can establish the diagnosis and permit early surgical repair of the dissection and fistula.

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