[HSF] Type I Dissection

[Tea Acuff]

Beta blockers, repeat scan at discharge and in few months. Or you could replace ascending aorta. I would choose medicine for myself.

tea


----- Original Message ----
From: Edward Bender <ebender001 at charter.net>
To: OpenHeart-L <OpenHeart-L at hsforum.com>
Sent: Tuesday, February 6, 2007 9:17:54 PM
Subject: [HSF] Type I Dissection


Here is an interesting patient that showed up in the emergency room  
today.  69 year old male with intermittent left flank and left upper  
quadrant abdominal pain for a week.  No other pain, neuro symptoms,  
weakness, etc.  He had a Hancock II valve placed 14 years ago at a  
major midwestern medical school without complication.  He has no  
angina or heart failure symptoms.  He is obese, so the ER physician  
obtained a CTA to rule out abdominal aortic aneurysm.  In 2004, he  
had a CT of his chest to follow a small ascending aortic aneurysm.   
The maximum ascending aortic dimension was 4.3 cm, stable from the  
previous year.  Below are representative pictures from today's CT scan:
Echocardiogram shows normally functioning aortic valve, good LVEF,  
and no regional wall motion abnormalities.  Creatinine is normal.   
Hct and WBC count is normal.  Would forum members care to discuss the  
approach to treating this patient?  I hope the pictures come through  
- if not, I will adjust things and try again.

Ed Bender, MD
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