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Case 3/2015 A 32-year-old female patient with coarctation of the aorta, bicuspid aortic valve and dilatation of the ascending aorta.

Atik E, Arrieta R, Kalil Filho R - Arq. Bras. Cardiol. (2015)

View Article: PubMed Central - PubMed

Affiliation: Hospital Sírio Libanês de São Paulo, São Paulo, SP, Brazil.

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Angiography showed clear narrowing in the aortic isthmus anddilatation of the AscAo and DescAo... Severe coarctation of the aorta in the isthmic regionand mild aortic valve stenosis in a bicuspid valve with marked ascending aortadilatation, in natural course... Noteworthy, despite the long-standing heart diseasewith pressure overload, no myocardial hypertrophy or signs of electric overload areobserved, and the symptoms are recent and mild... This results from the development of anefficient collateral circulation... Chest radiograph with normal cardiac silhouetteexpresses preserved ventricular function, and AscAo dilatation suggests the possibilityof DescAo obstruction, in addition to the aortic valve stenosis... Aortic obstruction in adulthood generally resultsfrom previous aortitis, as occurs in Takayasu and Kawasaki diseases; connective tissuediseases; and infectious diseases, such as syphilis... Dilatation of the isthmic region was chosen using therapeutic cardiaccatheterization from the right femoral artery with placement of a 40 x 20-mm stent justpast the origin of the left subclavian artery... BP levels immediately increased to 200mmHg and decreased in the sequence... Severe chest pain extending to the back persisted for 12 hours,accompanied by BP elevation to 150/100 mmHg; both were relieved by dolantine andbeta‑blockers... BP decreased to normal levels of 125/80 mmHg in upper and lower limbs.The systolic murmur of aortic valve stenosis remained unchanged... Cardiac compensation with maintained antegradeflow is achieved by the myocardial hypertrophy and development of collateralcirculation... In the present case, the favorable course up to the fourth decade of life,with more recent manifestation of symptoms, resulted from an efficient collateralcirculation... In the course of bicuspid aortic valve,unfavorable elements such as AscAo dilatation with deficiency of the parietalmuscle arise, and this shouldbe invariably treated surgically in due time.

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Chest radiograph shows normal cardiac silhouette, with slightly bulged right upperarch (dilated ascending aorta) and also dilated descending aorta. Hyperdensity canbe observed in some lower borders of ribs.
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f01: Chest radiograph shows normal cardiac silhouette, with slightly bulged right upperarch (dilated ascending aorta) and also dilated descending aorta. Hyperdensity canbe observed in some lower borders of ribs.

Mentions: Chest radiograph showed normal cardiac silhouette (cardiothoracic ratio of0.47). The pulmonary vascular network was normal and the arch of the pulmonary arterywas concave. The right upper arch was elongated, suggesting dilatation of the ascendingaorta (AscAo). The posterior aortic arch was somewhat prominent and the descending aorta(DescAo) was dilated. Hyperdensity was observed in some ribs (Figure 1).


Case 3/2015 A 32-year-old female patient with coarctation of the aorta, bicuspid aortic valve and dilatation of the ascending aorta.

Atik E, Arrieta R, Kalil Filho R - Arq. Bras. Cardiol. (2015)

Chest radiograph shows normal cardiac silhouette, with slightly bulged right upperarch (dilated ascending aorta) and also dilated descending aorta. Hyperdensity canbe observed in some lower borders of ribs.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4386856&req=5

f01: Chest radiograph shows normal cardiac silhouette, with slightly bulged right upperarch (dilated ascending aorta) and also dilated descending aorta. Hyperdensity canbe observed in some lower borders of ribs.
Mentions: Chest radiograph showed normal cardiac silhouette (cardiothoracic ratio of0.47). The pulmonary vascular network was normal and the arch of the pulmonary arterywas concave. The right upper arch was elongated, suggesting dilatation of the ascendingaorta (AscAo). The posterior aortic arch was somewhat prominent and the descending aorta(DescAo) was dilated. Hyperdensity was observed in some ribs (Figure 1).

View Article: PubMed Central - PubMed

Affiliation: Hospital Sírio Libanês de São Paulo, São Paulo, SP, Brazil.

AUTOMATICALLY GENERATED EXCERPT
Please rate it.

Angiography showed clear narrowing in the aortic isthmus anddilatation of the AscAo and DescAo... Severe coarctation of the aorta in the isthmic regionand mild aortic valve stenosis in a bicuspid valve with marked ascending aortadilatation, in natural course... Noteworthy, despite the long-standing heart diseasewith pressure overload, no myocardial hypertrophy or signs of electric overload areobserved, and the symptoms are recent and mild... This results from the development of anefficient collateral circulation... Chest radiograph with normal cardiac silhouetteexpresses preserved ventricular function, and AscAo dilatation suggests the possibilityof DescAo obstruction, in addition to the aortic valve stenosis... Aortic obstruction in adulthood generally resultsfrom previous aortitis, as occurs in Takayasu and Kawasaki diseases; connective tissuediseases; and infectious diseases, such as syphilis... Dilatation of the isthmic region was chosen using therapeutic cardiaccatheterization from the right femoral artery with placement of a 40 x 20-mm stent justpast the origin of the left subclavian artery... BP levels immediately increased to 200mmHg and decreased in the sequence... Severe chest pain extending to the back persisted for 12 hours,accompanied by BP elevation to 150/100 mmHg; both were relieved by dolantine andbeta‑blockers... BP decreased to normal levels of 125/80 mmHg in upper and lower limbs.The systolic murmur of aortic valve stenosis remained unchanged... Cardiac compensation with maintained antegradeflow is achieved by the myocardial hypertrophy and development of collateralcirculation... In the present case, the favorable course up to the fourth decade of life,with more recent manifestation of symptoms, resulted from an efficient collateralcirculation... In the course of bicuspid aortic valve,unfavorable elements such as AscAo dilatation with deficiency of the parietalmuscle arise, and this shouldbe invariably treated surgically in due time.

Show MeSH