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Eur J Cardiothorac Surg 2008;34:210. doi:10.1016/j.ejcts.2008.04.001
Copyright © 2008, European Association for Cardio-thoracic Surgery. Published by Elsevier. All rights reserved.
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Images in cardio-thoracic surgery

Cardiac compression by massive hematoma due to aneurysm rupture of the descending thoracic aorta

Yukihiro Matsuno*, Yoshio Mori, Hiroshi Takiya

Department of Cardiovascular Surgery, Gifu Prefectural General Medical Center, 4-6-1 Noishiki, Gifu City, Gifu 500-8717, Japan

Received 2 December 2007; received in revised form 26 March 2008; accepted 2 April 2008.

* Corresponding author. Tel.: +81 58 246 1111; fax: +81 58 248 3805. (Email: 44870{at}gifu-hp.jp).

Key Words: Aneurysm rupture • Hematoma • Cardiac tamponade

A 64-year-old man was admitted to our hospital with acute chest pain. Chest X-ray showed a huge widening of the mediastinal shadow (Fig. 1 ). Computed tomographic (CT) scan revealed the heart was compressed by a massive hematoma due to aneurysm rupture (Fig. 2 ). Urgent graft replacement was successfully performed.


Figure 1
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  		Fig. 1. Chest X-ray showed a huge widening of the mediastinal shadow.

 

Figure 2
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  		Fig. 2. Computed tomographic scan (A; axial slice, B; sagittal reconstruction) revealed a huge aneurysm of the descending thoracic aorta with a maximum diameter of approximately 9.0 cm, which was ruptured just above the diaphragm. The heart was compressed anteriorly by massive hematoma in the posterior mediastinum in a manner resembling cardiac tamponade. The massive hematoma extended to the bilateral thoracic cavity.

His physical examination revealed a neck vein dilatation. The blood pressure was 85/54 mmHg with a pulse of 114 beats/min. Heart sounds were diminished and the electrocardiogram showed a sinus tachycardia with low voltage.

 





This Article
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Right arrow Articles by Matsuno, Y.
Right arrow Articles by Takiya, H.
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Right arrow Articles by Matsuno, Y.
Right arrow Articles by Takiya, H.
Related Collections
Right arrow Professional affairs
Right arrow Mediastinum
Right arrow Great vessels

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