Pulmonary artery sheath haematoma with pulmonary arterial compression: A rare complication of type A aortic dissection mistaken for aortitis

摘要

An 89-year-old woman with a history of hypertension and temporal arteritis treated with cortico-steroid therapy presented complaining of moderate right-sided chest pain with shortness of breath beginning 1 day earlier. She had no fever, vomiting, syncope, or light headedness. CT aortography showed hyperattenuating aortic wall thickening with unenhanced imaging (arrow, Panel A, and crescentic low attenuation thickening following i.v. contrast administration (arrow, Panel 8, Figure S1B), interpreted as type A intramural haematoma; thoracic MRI (Panel Q suggested the same. Dobutamine stress echocardiography showed no inducible ischaemic changes, and transthoracic echocardiography showed normal left ventricular function without regional wall motion abnormalities.