MINI-SYMPOSIUM

Aortic intramural haematoma: natural history and predictive factors for complications

C A Nienaber, B M Richartz, T Rehders, H Ince, M Petzsch

Division of Cardiology at the University Hospital Rostock, Department of Internal Medicine, Rostock, Germany

Correspondence to:
Correspondence to:
Christoph A Nienaber, MD
Division of Cardiology, University Hospital of Rostock, Ernst-Heydemann-Str. 6, 18057 Rostock, Germany; christoph.nienaber@med.uni-rostock.de

Keywords: aortic intramural haematoma; penetrating atherosclerotic ulcers

The first 150 words of the full text of this article appear below.

Intramural haematoma (IMH) of the aorta is attracting growing interest as a variant of aortic dissection and is more frequently diagnosed by modern tomographic imaging modalities in the evaluation of acute aortic syndromes.^1,2 The evolution from IMH to overt dissection or even rupture may occur suddenly or is heralded by ongoing acute aortic (pain) syndrome. Unlike classic aortic dissection, IMH has no mechanisms of decompression by a re-entry tear but rather reveals intramural (intramedial) thickening or echolucent pockets of non-communicating blood with potential for rupture or, at times, regression and resorption of haematoma with time.^3–6 As in overt dissection, widening of the mediastinum or the aortic shadow, pleural effusion and pain, aortic regurgitation, and pericardial effusion may emerge after initial IMH, whereas focal neurological signs or malperfusion syndrome are incidental.⁷ Hence, the subtle initial pathology of IMH is more likely to be missed than overt dissection, especially in the absence . . . [Full text of this article]

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