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J Thorac Cardiovasc Surg 2007;134:1340-1341
© 2007 The American Association for Thoracic Surgery

Brief Communication

Acute type A aortic dissection mimicking a congenital supravalvular aortic membrane

^a Department of Cardiothoracic Surgery, Hammersmith Hospital, London, United Kingdom
^b Department of Imaging, Hammersmith Hospital, London, United Kingdom
^c Department of Cardiology, Hammersmith Hospital, London, United Kingdom.

Received for publication May 28, 2007; accepted for publication June 21, 2007.

^_* Address for reprints: Ioannis Dimarakis, MRCS, Department of Cardiothoracic Surgery, Imperial College London, Hammersmith Hospital Campus, Du Cane Rd, London W12 ONN, United Kingdom. (Email: ioannis.dimarakis@imperial.ac.uk).

The first 20% of the full text of this article appears below.

Clinical Summary

A 45-year-old construction worker presented to his local casualty department with a 3-week history of recurrent epigastric pain associated with shortness of breath on exertion. He was otherwise a healthy nonsmoker with no significant medical history. Clinical examination revealed tachycardia with pansystolic and diastolic decrescendo murmurs best heard at the lower left sternal border. A routine chest radiograph showed no abnormalities, and routine laboratory investigations showed mildly elevated levels of transaminases and C-reactive protein. Results of viral hepatitis screen and serial blood cultures were negative. Transthoracic and transesophageal echocardiograms suggested a membrane 2 cm above the aortic valve annulus within an aneurysm of the proximal ascending thoracic aorta (diameter 5 cm). Significant 4-chamber dilatation with impairment of left ventricular systolic function was noted; in addition, severe . . . [Full Text of this Article]