DOI QR코드

DOI QR Code

Aortic Dissection and Rupture in a Child

  • Jo, Yun-Ju (Department of Pediatric Cardiology, Kwandong University Myongji Hospital Cardiovascular Center) ;
  • Lee, Eun-Jeong (Department of Pediatric Cardiology, Kwandong University Myongji Hospital Cardiovascular Center) ;
  • Oh, Jin-Won (Department of Pediatric Cardiology, Kwandong University Myongji Hospital Cardiovascular Center) ;
  • Moon, Chang-Min (Department of Pediatric Cardiology, Kwandong University Myongji Hospital Cardiovascular Center) ;
  • Cho, Deok-Kyu (Department of Adult Cardiology, Kwandong University Myongji Hospital Cardiovascular Center) ;
  • Cho, Yun-Hyeong (Department of Adult Cardiology, Kwandong University Myongji Hospital Cardiovascular Center) ;
  • Byun, Ki-Hyun (Department of Adult Cardiology, Kwandong University Myongji Hospital Cardiovascular Center) ;
  • Eun, Lucy Young-Min (Department of Pediatric Cardiology, Kwandong University Myongji Hospital Cardiovascular Center)
  • Published : 2011.03.30

Abstract

After developing sudden severe chest pain, an 11-year-old boy presented to the emergency room with chest pain and palpitations and was unable to stand up. The sudden onset of chest pain was first reported while swimming at school about 30 minutes prior to presentation. Arterial blood pressure (BP) was 150/90 mmHg, heart rate was 120/minute, and the chest pain was combined with shortness of breath and diaphoresis. During the evaluation in the emergency room, the chest pain worsened and abdominal pain developed. An aortic dissection was suspected and a chest and abdomen CT was obtained. The diagnosis of aortic dissection type B was established by CT imaging. The patient went to surgery immediately with BP control. He died prior to surgery due to aortic rupture. Here we present this rare case of aortic dissection type B with rupture, reported in an 11-year-old Korean child.

Keywords

References

  1. Fikar CR, Fikar R. Aortic dissection in childhood and adolescence: an analysis of occurrence over a 10-year interval in New York State. Clin Cardiol 2009;32:E23-6.
  2. Cooper DR, Lucke WC, Moseson DL. Aortic dissection in adolescence. Am Fam Physician 1986;34:137-42.
  3. Horwitz AE, Benz-Bohm G, Heuser L, Crespo E, Dalichau H. Aortic dissection in childhood: occurrence and diagnostic procedure. Mona-tsschr Kinderheilkd 1986;134:28-31.
  4. Fikar CR, Koch S. Etiologic factors of acute aortic dissection in children and young adults. Clin Pediatr (Phila) 2000;39:71-80. https://doi.org/10.1177/000992280003900201
  5. Fikar CR, Amrhein JA, Harris JP, Lewis ER. Dissecting aortic aneurysm in childhood and adolescence: case report and literature review. Clin Pediatr (Phila) 1981;20:578-83. https://doi.org/10.1177/000992288102000904
  6. Teien D, Finley JP, Murphy DA, Lacson A, Longhi J, Gillis DA. Idiopathic dilatation of the aorta with dissection in a family without Marfan syndrome. Acta Paediatr Scand 1991;80:1246-9. https://doi.org/10.1111/j.1651-2227.1991.tb11818.x
  7. Mitsnefes MM. Hypertension in children and adolescents. Pediatr Clin North Am 2006;53:493-512. https://doi.org/10.1016/j.pcl.2006.02.008
  8. Hatzaras IS, Bible JE, Koullias GJ, Tranquilli M, Singh M, Elefteriades JA. Role of exertion or emotion as inciting events for acute aortic dissection. Am J Cardiol 2007;100:1470-2. https://doi.org/10.1016/j.amjcard.2007.06.039
  9. Edwin F, Aniteye EA, Sereboe L, Frimpong-Boateng K. Acute aortic dissection in the young: distinguishing precipitating from predisposing factors. Interact Cardiovasc Thorac Surg 2009;9:368.
  10. Gray J, McCaw T, McGovern S. Spontaneous chest pain in a 14-year-old boy. Eur J Emerg Med 2005;12:253-4. https://doi.org/10.1097/00063110-200510000-00012
  11. Rizzoli G, Scalia D, Casarotto D, Tiso E. Aortic dissection type A ver-sus type B: a different post-surgical death hazard? Eur J Cardiothorac Surg 1997;12:202-8. https://doi.org/10.1016/S1010-7940(97)00157-7
  12. Schor JS, Yerlioglu ME, Galla JD, Lansman SL, Ergin MA, Griepp RB. Selective management of acute type B aortic dissection: long-term follow-up. Ann Thorac Surg 1996;61:1339-41. https://doi.org/10.1016/0003-4975(96)00105-1
  13. Hashimoto A, Kimata S, Hosoda S. Acute aortic dissection: a compari-son between the results of medical and surgical treatments. Jpn Circ J 1991;55:821-3. https://doi.org/10.1253/jcj.55.821
  14. Cho SH, Sung K, Park KH, et al. Midterm results of aortic arch repla-cement in a Stanford type A aortic dissection with an intimal tear in the aortic arch. Korean Circ J 2009;39:270-4. https://doi.org/10.4070/kcj.2009.39.7.270
  15. Qureshi SA. Use of covered stents to treat coarctation of the aorta. Korean Circ J 2009;39:261-3. https://doi.org/10.4070/kcj.2009.39.7.261
  16. Park SH, Park HS, Lee JH, et al. A case of coronary artery dissection after aortic replacement in acute type A aortic dissection. Korean Circ J 2009;39:428-3. https://doi.org/10.4070/kcj.2009.39.10.428
  17. Lee S, Kim W, Hwang SH, et al. The relationship of inflammatory reaction with the mortality of type B acute aortic syndrome. Korean Circ J 2006;36:387-92. https://doi.org/10.4070/kcj.2006.36.5.387
  18. Kang WC, Joung BY, Ko YG, et al. Favorable outcome of endovascular stent-graft implantation for Stanford type B aortic dissection. Korean Circ J 2003;33:457-64.
  19. Fishbein MC. Cardiac disease and risk of sudden death in the young the burden of the phenomenon. Cardiovasc Pathol 2009. [Epub ahead of print]
  20. DeSanctis RW, Doroghazi RM, Austen WG, Buckley MJ. Aortic dissection. N Engl J Med 1987;317:1060-7. https://doi.org/10.1056/NEJM198710223171705

Cited by

  1. Aortic Dissection in Hospitalized Children and Young Adults: A Multiinstitutional Study : Aortic dissection in the young vol.9, pp.1, 2011, https://doi.org/10.1111/chd.12090