A 71 year old lady presents with chest pain radiating to her back. Initial BP 95/60, repeat on other arm 105/65, pulse 100/min regular, RR 16 /min.
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Describe and interpret this CXR
CHEST X-RAY INTERPRETATION
There is aneurysmal dilation and unfolding of the thoracic aorta.
Heart size is possibly enlarged. Left base is indistinct raising possibility of a pleural effusion.
CT Angiogram Interpretation:
CT angiogram demonstrates a dissection flap in the descending aorta.
The key important issue is to distinguish between an ascending OR descending dissection.
This case was in fact an ascending dissection (i.e. Stanford type A or DeBakey type I). This needs surgery.
Having proposed a classification of aortic dissection, at age 97 DeBakey himself developed aortic dissection
Michael Ellis DeBakey (1908-2008) also engineered elements of the first cardiopulmonary bypass machine, pioneered carotid endartectomy and the use of dacron vascular grafts.
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