Mega aorta syndrome: a case of thoracic and abdominal aortic aneurysm

The American Journal of Emergency Medicine
William C WuDerek Linklater

Abstract

An 83-year-old woman presented to the emergency department (ED) via emergency medical services with the chief complaint of "strokelike symptoms." Physical examination revealed altered mental status, tachycardia, hypotension, and a large nonpulsatile periumbilical mass. Bedside ultrasound revealed a 9-cm abdominal aortic aneurysm with absent central flow. Computed tomography scan demonstrated diffuse thoracic and abdominal aortic dilation with rupture into the mediastinum along with left hemothorax. Repeat beside ultrasound demonstrated abdominal aortic aneurysm rupture not seen on the computed tomography scan. Despite aggressive resuscitation, the patient developed bradycardia, which devolved into pulseless electric activity cardiac arrest. She was unable to be resuscitated. The patient's diffuse aneurysmal dilation places her into the small category of patients with a disease entity known as mega aorta syndrome (MAS). Mega aorta syndrome is defined as aneurysmal dilation of the aorta to greater than 6 cm in diameter. Although not in our case, most cases of MAS are symptomatic before catastrophic presentation. The disease progression for these patients is slow and occurs over years. When this disease is recognized early, a surg...Continue Reading

References

Jun 1, 1995·Japanese Circulation Journal·S AoyagiK Oishi
Oct 3, 2002·Cardiovascular Surgery : Official Journal of the International Society for Cardiovascular Surgery·Peter Gloviczki
Jun 30, 2004·The Annals of Thoracic Surgery·Lars G SvenssonDelos M Cosgrove

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Citations

Nov 12, 2016·International Journal of Cardiology·Ulrike BaranyiBarbara Messner
Mar 23, 2012·Innovations : Technology and Techniques in Cardiothoracic and Vascular Surgery·Giampiero EspositoCataldo Labriola
Jan 16, 2019·Emergency Radiology·Franco VerdeElliot K Fishman

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