Rupture of a heavily calcified aortic arch in a patient with aortitis syndrome advanced atherosclerosis and renal ischemia: a dilemma between appropriate blood pressure control and maintenance of renal perfusion

摘要

Imaging and clinical course during the hospitalization period. a A chest X-ray film on admission. A giant heart and bilateral pulmonary edema were observed. The aortic arch was heavily calcified. b Computed tomography on admission. The abdominal aorta was heavily calcified at the levels of the entry sites of the bilateral renal arteries. Both kidneys were atrophied, with more prominent atrophy of the left kidney, indicating hypoperfusion of the left kidney (white arrows). c Serial changes in the serum Cr level, SBP, and DBP during the hospitalization period. d Computed tomography at the time of hemoptysis. Rupture was observed in the heavily calcified aortic wall, which perforated into the bronchus. Cr creatinine, DBP diastolic blood pressure, SBP systolic blood pressure