RESUMEN
Acquired coarctation of the thoracic aorta is a rare phenomenon in adults. The etiology is often idiopathic, but severe stenosis can develop from prior surgery, blunt thoracic aortic injuries, or severe atherosclerotic/atheroembolic disease. Common symptomatic presentations include refractory upper extremity hypertension and new-onset congestive heart failure. We present the case of a 52-year-old man who developed acquired thoracic aortic coarctation 30 years after a blunt trauma and deceleration injuries to the aorta requiring open surgical aortic repair. He presented with poorly controlled hypertension and new-onset heart failure and was treated surgically with endovascular repair.
Asunto(s)
Aorta Torácica/cirugía , Implantación de Prótesis Vascular , Procedimientos Endovasculares , Insuficiencia Cardíaca/etiología , Traumatismos Torácicos/cirugía , Lesiones del Sistema Vascular/cirugía , Heridas no Penetrantes/cirugía , Accidentes de Tránsito , Aorta Torácica/diagnóstico por imagen , Aorta Torácica/lesiones , Aortografía/métodos , Constricción Patológica , Insuficiencia Cardíaca/diagnóstico , Humanos , Masculino , Persona de Mediana Edad , Traumatismos Torácicos/diagnóstico , Traumatismos Torácicos/etiología , Factores de Tiempo , Tomografía Computarizada por Rayos X , Resultado del Tratamiento , Lesiones del Sistema Vascular/diagnóstico , Lesiones del Sistema Vascular/etiología , Heridas no Penetrantes/diagnóstico , Heridas no Penetrantes/etiologíaRESUMEN
Coarctation of the aorta, virtually always a congenital malformation, is characterized by localized aortic narrowing, usually in the arch opposite to the ductus arteriosus and just distal to the left subclavian artery. The condition occasionally goes undiagnosed until adulthood. We report a case of a 55-year-old man who presented with uncontrolled hypertension, pulmonary edema, and non-ST-segment elevation myocardial infarction due to multi-vessel coronary artery disease. He underwent successful simultaneous coronary artery bypass grafting and coarctation repair using an ascending-to-descending aortic bypass graft.
Asunto(s)
Coartación Aórtica/diagnóstico por imagen , Coartación Aórtica/cirugía , Puente de Arteria Coronaria , Edema Pulmonar/diagnóstico por imagen , Aorta Torácica/cirugía , Angiografía por Tomografía Computarizada , Electrocardiografía , Humanos , Masculino , Persona de Mediana Edad , Infarto del Miocardio sin Elevación del ST/etiología , Edema Pulmonar/etiología , Radiografía TorácicaRESUMEN
Background: Syncope is a common complaint in clinical practice. The etiologies and mechanisms can be multiple and complex. Syncope caused by a mediastinal mass compressing the vagus nerve is rare. Case Report: We report the case of a patient who presented to the emergency department experiencing recurrent syncope. Imaging revealed a large, calcified mass in the right paratracheal region. After intracranial lesions, cardiac arrhythmias, and orthostatic hypotension were excluded, we suspected that the syncope was related to vagus nerve compression. The patient underwent surgical resection of a mediastinal mass and had complete resolution of syncopal episodes after surgery. Conclusion: This case outcome suggests that recurrent syncope could be the first symptom of an intrathoracic mass.
Asunto(s)
Secuestro Broncopulmonar/complicaciones , Hemoptisis/diagnóstico , Enfermedad Aguda , Adulto , Secuestro Broncopulmonar/diagnóstico , Secuestro Broncopulmonar/cirugía , Diagnóstico Diferencial , Femenino , Hemoptisis/etiología , Hemoptisis/cirugía , Humanos , Neumonectomía/métodos , Índice de Severidad de la Enfermedad , Cirugía Torácica Asistida por Video , Tomografía Computarizada por Rayos XRESUMEN
We present the case of a 72-year-old man with hemoptysis after a thoracic projectile injury, which occurred while mowing the lawn. Chest radiograph followed by a computed tomography angiogram revealed a metallic foreign body in the right middle lobe of the lung. The patient underwent a right anterolateral thoracotomy where the object was successfully retrieved. The patient had an uneventful postoperative recovery.