A triple-lumen aorta: an unusual manifestation of complex aortic pathology associated with crack cocaine abuse.

摘要

A 61-YEAR-OLD woman with a history of poorly controlled hypertension, hyperlipidemia, coronary artery disease, and a chronic Stanford type B aortic dissection presented to a community hospital with severe chest pain radiating to her upper back associated with recent inhalation of crack cocaine. The chronic type B dissection was conservatively managed when it occurred several years before the current episode, but the patient had not bee'n compliant with antihypertensive medications nor had she consistently participated in routine radiologic evaluation of the descending thoracic aorta. The patient was treated with intravenous infusions of esmolol and sodium nitroprusside, and she was transferred to this institution for further evaluation and treatment. A transesophageal echocardiogram (TEE) was performed that revealed the following images (Figs 1-3). What is the diagnosis?