IMAGING IN CARDIOLOGY
A
young woman with atypical chest pain
G.M.F. Ruinemans, J.I. Darmanata, M. Kraai
Figure 1. Chest X-ray: the aneurysm prduces a widening of the mediastinal silbouette and enlargement of the aortic knob.
G.M.F. Rulnemans .l.Dan Department of Cardiology, Twenteborg Hospital, Almelo M. Kraal Department of Radiology, Twenteborg Hospital, Almelo
Correspondence to: G.M.F. Ruinemans Department of Cardiology, Twenteborg Hospital, PO Box 7600 7600 SZ Almelo E-mail: [email protected]
Netherlands Heart Journal, Volume 13, Number 2, February 2005
A 33-year-old woman presented at the emergency department with a slight sharp anterior chest pain without radiation and some exertional dyspnoea. She had been diagnosed with hypertension six months previously. On physical examination, she was a well-developed woman with normal stature and not in acute distress. BP was 220/130 mmnHg (symmetrical value on both arms). Laboratory findings showed a haemoglobin of 9.1 (7.1-9.8 mmol/l), aspartate aminotransferase 30 65
IMAGING IN CARDIOLOGY
I~ ~ ~ ~.,
00 WA~~~~~~~~~~~~~~~~~
Figure 2. CTscan of the tbora= two dixnctlumens witb a visible intimalflap can be identified (arrow), no kakage present. (0-40 U/1), hydroxybutyrate dehydrogenase 203 (70-180 U/1), creatine kinase-MB 252 (0-170 U/1), creatinine 54 (55-90 ,umol/1) and potassium 2.6 (3.5-4.7 mmol/1). The ECG was within normal limits.
A chest X-ray showed mediastinal and aortic widening (figure 1) and a computed chest tomography showed a dissection from the proximal descending aorta to the infrarenal region, with a true lumen diameter of0.95 x 0.94 cm and a false lumen diameter of 3.9 x 3.5 cm
(figure 2).
In this section a remarkable 'image' is presented and a short comment is given. We invite you to send in images (in triplicate) with a short comment (one to two pages at the most) to Bohn Stafleu van Loghum, Postbus 246, 3990 GA Houten, e-mail: [email protected]. This section is edited by M.J.M. Cramer andjj. Bax.
66
In conclusion, a type B thoracic dissection (Stanford classification) in a young woman with almost no (typical) symptoms.' E Reference 1
Isselbachter EM. Diseases ofthe aorta. In: Braunwald E, ed. A textbook of cardiovascular medicine. Philadelphia: Saunders, 2001: 1422-56.
Netherlands Heart Journal, Volume 13, Number 2, February 2005
A
young woman with atypical chest pain
G.M.F. Ruinemans, J.I. Darmanata, M. Kraai
Figure 1. Chest X-ray: the aneurysm prduces a widening of the mediastinal silbouette and enlargement of the aortic knob.
G.M.F. Rulnemans .l.Dan Department of Cardiology, Twenteborg Hospital, Almelo M. Kraal Department of Radiology, Twenteborg Hospital, Almelo
Correspondence to: G.M.F. Ruinemans Department of Cardiology, Twenteborg Hospital, PO Box 7600 7600 SZ Almelo E-mail: [email protected]
Netherlands Heart Journal, Volume 13, Number 2, February 2005
A 33-year-old woman presented at the emergency department with a slight sharp anterior chest pain without radiation and some exertional dyspnoea. She had been diagnosed with hypertension six months previously. On physical examination, she was a well-developed woman with normal stature and not in acute distress. BP was 220/130 mmnHg (symmetrical value on both arms). Laboratory findings showed a haemoglobin of 9.1 (7.1-9.8 mmol/l), aspartate aminotransferase 30 65
IMAGING IN CARDIOLOGY
I~ ~ ~ ~.,
00 WA~~~~~~~~~~~~~~~~~
Figure 2. CTscan of the tbora= two dixnctlumens witb a visible intimalflap can be identified (arrow), no kakage present. (0-40 U/1), hydroxybutyrate dehydrogenase 203 (70-180 U/1), creatine kinase-MB 252 (0-170 U/1), creatinine 54 (55-90 ,umol/1) and potassium 2.6 (3.5-4.7 mmol/1). The ECG was within normal limits.
A chest X-ray showed mediastinal and aortic widening (figure 1) and a computed chest tomography showed a dissection from the proximal descending aorta to the infrarenal region, with a true lumen diameter of0.95 x 0.94 cm and a false lumen diameter of 3.9 x 3.5 cm
(figure 2).
In this section a remarkable 'image' is presented and a short comment is given. We invite you to send in images (in triplicate) with a short comment (one to two pages at the most) to Bohn Stafleu van Loghum, Postbus 246, 3990 GA Houten, e-mail: [email protected]. This section is edited by M.J.M. Cramer andjj. Bax.
66
In conclusion, a type B thoracic dissection (Stanford classification) in a young woman with almost no (typical) symptoms.' E Reference 1
Isselbachter EM. Diseases ofthe aorta. In: Braunwald E, ed. A textbook of cardiovascular medicine. Philadelphia: Saunders, 2001: 1422-56.
Netherlands Heart Journal, Volume 13, Number 2, February 2005
