SESSION TITLE: Student/Resident Case Report Poster - Cardiac and Thoracic Surgery
SESSION TYPE: Student/Resident Case Report Poster
PRESENTED ON: Tuesday, October 25, 2016 at 01:30 PM - 02:30 PM
INTRODUCTION: An interesting presentation of complete aortic dissection in a patient with minimal risk factors.
CASE PRESENTATION: 46-year-old female with past medical history of morbid obesity, hypertension presented with achy, midsternal chest pain for six hours. It was constant, 7/10, non-radiating, worse with deep inspiration, and with one episode of vomiting. She received no relief from Aspirin, Nitro, nor Morphine. Review of symptoms was unremarkable except for left sided abdominal pain. She was a non-smoker and non-compliant with her hypertensive medications. Her vital signs on admission were BP 120/86 in the left and right arm, HR 78, and respiration rate 26. She had sternal and left abdominal tenderness. Labs including cardiac biomarkers were within normal limits except for an elevated creatinine of 1.25 with no baseline and d-dimer greater than 1000. Chest x-ray showed widened mediastinum. EKG showed normal sinus rhythm with nonspecific t wave changes. A CT Angiogram showed an ascending dissection that continued into the bilateral common iliac arteries infarcting the inferior pole of the left kidney. She was taken to the operating room for an emergent aortic repair and was discharged after one week.