intramural aortic hematoma

Classification

• A type: involve the ascending aorta or aortic arch
• B type: begin distal to the left subclavian artery

Clinical manifestations

• chest pain
• hypertension

Laboratory

• plasma D-dimer may be elevated

Radiology

• contrast CT of thorax
  • seen as circuferential soft tissue density without contrast enhancement

Complications

• malperfusion syndromes

Differential diagnosis

• thoracic aortic aneurysm

Management

• type A: emergency surgery
• type B:
  • intravenous beta-blocker & nitroprusside as needed for blood pressure control
  • surgery for malperfusion or significant aneurysmal dilatation

More general terms

• hematoma
• vascular disease (vasculopathy)