Journal Article

Acute pleural effusion from aortic aneurysm rupture

Sun, Dongmei, Wells, Malcolm M.

2014

Overview

A computed tomograph of the patient's thorax showed a large lower descending thoracic aortic aneurysm (7.7 × 8.8 cm), with discontinuity of the posterior wall and a large extrapleural fluid collection; these findings were both suggestive of a hemorrhaging ruptured aortic aneurysm (Appendix 1, available at www.cmaj .ca /lookup /suppl/doi:10.1503 /cmaj.130056 /-/DC1). Within an hour, the patient's chest pain became tearing in quality and radiated to his back. Examination showed tachycardia (160 beats/min), a pulse deficit and a large difference in blood pressure between arms (right arm: 160/70 mm Hg; leftarm: 70/30 mm Hg). He eventually became hypotensive with blood pressure of 70/30 mm Hg in his right arm and undetectable blood pressure in his leftarm. Emergency endovascular repair of the ruptured aortic aneurysm was successful.

• Publisher: Elsevier Inc,Joule Inc,CMA Impact, Inc,Canadian Medical Association
• Subject: Aged / Aneurysm, Ruptured - complications / Aneurysm, Ruptured - diagnostic imaging / Aneurysm, Ruptured - surgery / Aneurysms / Angioplasty - methods / Aortic Aneurysm, Thoracic - complications / Aortic Aneurysm, Thoracic - diagnostic imaging / Aortic Aneurysm, Thoracic - surgery / Aortic aneurysms / Case studies / Causes of / Chest Pain - diagnosis / Chest Pain - etiology / Complications and side effects / Diagnosis / Follow-Up Studies / Humans / Male / Medical diagnosis / Pleural Effusion - diagnostic imaging / Pleural Effusion - etiology / Pleural effusions / Practice / Radiography, Thoracic - methods / Risk Assessment / Risk factors / Tomography / Tomography, X-Ray Computed - methods / Treatment Outcome