RT Journal Article
SR Electronic
T1 An unusual finding in a 57-year-old woman with new onset hypertension and a diastolic murmur
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP 1762
OP 1762
DO 10.1136/heartjnl-2016-309661
VO 102
IS 21
A1 Jason M Tarkin
A1 James H F Rudd
A1 David R Jayne
A1 Rosemary A Rusk
A1 Deepa Gopalan
YR 2016
UL http://heart.bmj.com/content/102/21/1762.abstract
AB Clinical introduction A 57-year-old woman presented to our clinic with breathlessness brought on while walking uphill. She had been recently diagnosed with systemic hypertension. There was no known family history of cardiac disease, or prior smoking habit. On examination, pulse was 73 bpm and blood pressure 155/73 mm Hg, which was asymmetrical in her arms. Auscultation revealed a readily audible early diastolic murmur in the aortic area and bilateral subclavian bruits. ECG showed sinus rhythm with no abnormality. Transthoracic echocardiography demonstrated mild-to-moderate aortic regurgitation, and normal left ventricular size and function. The ascending aorta was mildly dilated (41 mm), with para-aortic thickening noted. Owing to the abnormal appearance of the aortic wall, cardiac MRI, and subsequently 18F-fluorodeoxyglucose (FDG) positron emission tomography (PET) scan was performed (figure 1).Question Which complication of the underlying disease is evident in figure 1, panel C? Aortic aneurysmAortic dissectionAortic thrombusCoronary artery aneurysmCoronary sinus fistula