The Journal of Emergency Medicine

2012

DOI: 10.1016/j.jemermed.2011.01.026

|View full text |Cite

|

Sign up to set email alerts

|

Penetrating Atherosclerotic Ulcerative Disease of the Aorta: Do Emergency Physicians Need to Worry?

Carlos J. Roldan

¹

Help me understand this report

Search citation statements

Order By: Relevance

Paper Sections

Select...

Discussion2

Introduction2

Acute Aortic Syndrome (Aas): Dissection and Variants1

Citation Types

Supporting

0

Mentioning

23

Contrasting

0

Year Published

2014

2014

2022

2022

Publication Types

Select...

Article9

Relationship

Self Cite0

Independent9

Authors

Journals

Cited by 12 publications

(23 citation statements)

References 52 publications

Supporting

0

Mentioning

23

Contrasting

0

Order By: Relevance

“…Acute aortic syndrome (AAS) is a constellation of aortic dissection, IMH, and penetrating atherosclerotic disease. With recent developments in diagnostic modalities, PAU has been frequently identified over the past few years with 2.3–7.6% estimated prevalence in symptomatic patients with AAS, but its background and actual incidence remains unknown ( 5 , 6 ). PAU usually develops in old age, atherosclerotic disease, coronary artery disease, hypertension, hyperlipidemia, a strong smoking history, and renal disease ( 7 , 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, PAU was diagnosed by aortography; however, since the early 1980s, CTA, MRI, and TTE have replaced aortography to diagnose aortic pathology. Table 1 summarizes the radiologic findings of PAU ( 6 , 8 , 12 , 13 ). However, CTA is the best diagnostic choice in PAU ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

An uncommon cause of chest pain – penetrating atherosclerotic aortic ulcer

¹

,

²

,

et al. 2016

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Chest pain is a very common symptom and can be of cardiac or non-cardiac origin. It accounts for approximately 5.5 million annual emergency room visits in the United States, according to 2011 CDC data. Penetrating atherosclerotic aortic ulcer (PAU), an uncommon condition, is also a potential cause of chest pain. We here report the case of a 65-year-old woman who presented with atypical chest and back pain. The pain persisted for 4 weeks necessitating two emergency room visits. Initial tests were non-significant including cardiac troponins, an electrocardiogram (EKG), and a chest X-ray on her first visit. Upon her second visit, she underwent a computed tomography angiogram of chest with contrast which revealed a PAU with an intramural hematoma in descending aorta. The PAU was finally diagnosed with an exclusion of other chest pain causes. She was treated non-surgically with a blood pressure control strategy and pain management. After a 2-month period of smoking cessation and following the achievement of a controlled blood pressure, she felt well without chest pain.

“…Acute aortic syndrome (AAS) is a constellation of aortic dissection, IMH, and penetrating atherosclerotic disease. With recent developments in diagnostic modalities, PAU has been frequently identified over the past few years with 2.3–7.6% estimated prevalence in symptomatic patients with AAS, but its background and actual incidence remains unknown ( 5 , 6 ). PAU usually develops in old age, atherosclerotic disease, coronary artery disease, hypertension, hyperlipidemia, a strong smoking history, and renal disease ( 7 , 8 ).…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, PAU was diagnosed by aortography; however, since the early 1980s, CTA, MRI, and TTE have replaced aortography to diagnose aortic pathology. Table 1 summarizes the radiologic findings of PAU ( 6 , 8 , 12 , 13 ). However, CTA is the best diagnostic choice in PAU ( 8 ).…”

Section: Discussionmentioning

confidence: 99%

An uncommon cause of chest pain – penetrating atherosclerotic aortic ulcer

¹

,

²

,

et al. 2016

Journal of Community Hospital Internal Medicine Perspectives

View full text Add to dashboard Cite

Chest pain is a very common symptom and can be of cardiac or non-cardiac origin. It accounts for approximately 5.5 million annual emergency room visits in the United States, according to 2011 CDC data. Penetrating atherosclerotic aortic ulcer (PAU), an uncommon condition, is also a potential cause of chest pain. We here report the case of a 65-year-old woman who presented with atypical chest and back pain. The pain persisted for 4 weeks necessitating two emergency room visits. Initial tests were non-significant including cardiac troponins, an electrocardiogram (EKG), and a chest X-ray on her first visit. Upon her second visit, she underwent a computed tomography angiogram of chest with contrast which revealed a PAU with an intramural hematoma in descending aorta. The PAU was finally diagnosed with an exclusion of other chest pain causes. She was treated non-surgically with a blood pressure control strategy and pain management. After a 2-month period of smoking cessation and following the achievement of a controlled blood pressure, she felt well without chest pain.

“…Most PAUs are asymptomatic and do not require urgent invasive treatment. However, it may be a progressive disease leading to a saccular (pseudo)aneurysm, AD, or transmural aortic rupture (40% of symptomatic PAUs), and emergency invasive therapy (often TEVAR) is recommended [ 21 , 24 , 25 , 89 , 90 , 91 ].…”

Section: Acute Aortic Syndrome (Aas): Dissection and Variantsmentioning

confidence: 99%

MDCT Imaging of Non-Traumatic Thoracic Aortic Emergencies and Its Impact on Diagnosis and Management—A Reappraisal

¹

,

²

,

³

et al. 2022

View full text Add to dashboard Cite

Non-traumatic thoracic aorta emergencies are associated with significant morbidity and mortality. Diseases of the intimomedial layers (aortic dissection and variants) have been grouped under the common term of acute aortic syndrome because they are life-threatening conditions clinically indistinguishable on presentation. Patients with aortic dissection may present with a wide variety of symptoms secondary to the pattern of dissection and end organ malperfusion. Other conditions may be seen in patients with acute symptoms, including ruptured and unstable thoracic aortic aneurysm, iatrogenic or infective pseudoaneurysms, aortic fistula, acute aortic thrombus/occlusive disease, and vasculitis. Imaging plays a pivotal role in the patient’s management and care. In the emergency room, chest X-ray is the initial imaging test offering a screening evaluation for alternative common differential diagnoses and a preliminary assessment of the mediastinal dimensions. State-of-the-art multidetector computed tomography angiography (CTA) provides a widely available, rapid, replicable, noninvasive diagnostic imaging with sensitivity approaching 100%. It is an impressive tool in decision-making process with a deep impact on treatment including endovascular or open surgical or conservative treatment. Radiologists must be familiar with the spectrum of these entities to help triage patients appropriately and efficiently. Understanding the imaging findings and proper measurement techniques allow the radiologist to suggest the most appropriate next management step.

“…Penetrating aortic ulcer (PAU) is a rare emergency department (ED) pathology with an estimated prevalence among patients with acute aortic syndromes (AAS) ranging from 2.3% to 7.6% [1,2]. This pathology is defined by progressive ulceration through the internal elastic lamina into the tunica media of the aorta [1]. AAS includes a family of life-threatening pathologies.…”

Section: Introductionmentioning

confidence: 99%

Penetrating Aortic Ulceration With Pseudoaneurysm and Intramural Hematoma: Emergency Department Management and Point-of-Care Ultrasound Diagnosis

et al. 2022

View full text Add to dashboard Cite

Penetrating aortic ulcer (PAU) complicated by an intramural hematoma is a rare and potentially lifethreatening emergency department (ED) presentation that is defined by progressive ulceration through the intima layer into the media layer of the aorta. Symptomatic PAUs can be clinically indistinguishable from other life-threatening pathologies such as aortic dissection, acute coronary syndrome (ACS), intrabdominal catastrophes as well as less lethal processes such as musculoskeletal back pain. Given the potential of PAUs to result in lethal aortic rupture and dissection, the emergency provider should maintain a high index of suspicion in patients with risk factors for aortic pathologies and utilize diagnostic modalities such as point-of-care ultrasound (POCUS) to expedite diagnosis.

scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.

Contact Info

customersupport@researchsolutions.com

10624 S. Eastern Ave., Ste. A-614

Henderson, NV 89052, USA

Product

Browser Extension Assistant by scite Citation Statement Search Reference Check Visualizations Dashboards Explore Journals Explore Organizations Explore Funders Embedding Badge Embedding Citation Search Pricing

Resources

Blog Help & FAQ Accessibility Statement API Terms For Universities & Governments For Researchers For Publishers For Corporate, Pharma & Enterprise Author Marketing Become an Affiliate Get an organization trial or quote scite Data & Services

About

News & Press Careers Read our Paper Coverage

This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.

Blog Terms and Conditions API Terms Privacy Policy Contact Cookie Preferences Do Not Sell or Share My Personal Information

Copyright © 2024 scite LLC. All rights reserved.

Made with 💙 for researchers

Part of the Research Solutions Family.