CXR Case 132

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

CXR 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.


CLINICAL CORRELATION

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.


CLINICAL PEARLS

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.


TOP 150 CXR SERIES



Prof Fraser Brims Curtin Medical School, acute and respiratory medicine specialist, immediate care in sport doc, ex-Royal Navy, academic| Top 100 CXR | Google Scholar |

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