Contrast Agent Pooling in the Descending Aorta Due to Severe Heart Failure
Case presentation: An 86-year-old female presented to our emergency department with chest pain and orthopnea and was diagnosed with heart failure and ST-elevation myocardial infarction, prompting hospitalization. During hospitalization, she developed a fever. A chest and abdominal contrast-enhanced...
Saved in:
| Main Authors: | , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
eScholarship Publishing, University of California
2024-11-01
|
| Series: | Clinical Practice and Cases in Emergency Medicine |
| Online Access: | https://escholarship.org/uc/item/76b3d8dh |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1846102234174062592 |
|---|---|
| author | Yosuke Maezawa Kazuya Nagasaki Hiroyuki Kobayashi Shunsuke Sakai Toshiyuki Irie |
| author_facet | Yosuke Maezawa Kazuya Nagasaki Hiroyuki Kobayashi Shunsuke Sakai Toshiyuki Irie |
| author_sort | Yosuke Maezawa |
| collection | DOAJ |
| description | Case presentation: An 86-year-old female presented to our emergency department with chest pain and orthopnea and was diagnosed with heart failure and ST-elevation myocardial infarction, prompting hospitalization. During hospitalization, she developed a fever. A chest and abdominal contrast-enhanced computed tomography (CT), conducted to investigate the cause of the fever, coincidentally revealed sedimentation of contrast agent in the descending aorta. To differentiate from aortic dissection, we conducted dynamic CT, and it was confirmed that the contrast agent within the aorta decreased over time. On the same day, an echocardiogram revealed a left ventricular ejection fraction of 36% with reduced contractile function, and a stagnant, hazy echo within the descending aorta. Discussion: In aortic dissection, the retention of contrast agent in the false lumen of the aorta is a crucial finding for diagnosis. However, we experienced a case where contrast agent accumulated in the descending aorta, caused by low ejection fraction of the left ventricle. Differential diagnosis from aortic dissection may be possible due to the gradual decrease in contrast agent over time. This case is valuable to report given the limited number of previous reports on this phenomenon. |
| format | Article |
| id | doaj-art-d96c2af9e5674e31a72ee738bb2c287c |
| institution | Kabale University |
| issn | 2474-252X |
| language | English |
| publishDate | 2024-11-01 |
| publisher | eScholarship Publishing, University of California |
| record_format | Article |
| series | Clinical Practice and Cases in Emergency Medicine |
| spelling | doaj-art-d96c2af9e5674e31a72ee738bb2c287c2024-12-27T19:12:08ZengeScholarship Publishing, University of CaliforniaClinical Practice and Cases in Emergency Medicine2474-252X2024-11-018437237410.5811/cpcem.20340cpcem-8-372Contrast Agent Pooling in the Descending Aorta Due to Severe Heart FailureYosuke MaezawaKazuya Nagasaki0Hiroyuki Kobayashi1Shunsuke Sakai2Toshiyuki Irie3Mito Kyodo General Hospital, Department of Internal Medicine, University of Tsukuba, Mito, JapanMito Kyodo General Hospital, Department of Internal Medicine, University of Tsukuba, Mito, JapanMito Kyodo General Hospital, Department of Cardiology, University of Tsukuba, Mito, JapanMito Kyodo General Hospital, Department of Radiology, University of Tsukuba, Mito, JapanCase presentation: An 86-year-old female presented to our emergency department with chest pain and orthopnea and was diagnosed with heart failure and ST-elevation myocardial infarction, prompting hospitalization. During hospitalization, she developed a fever. A chest and abdominal contrast-enhanced computed tomography (CT), conducted to investigate the cause of the fever, coincidentally revealed sedimentation of contrast agent in the descending aorta. To differentiate from aortic dissection, we conducted dynamic CT, and it was confirmed that the contrast agent within the aorta decreased over time. On the same day, an echocardiogram revealed a left ventricular ejection fraction of 36% with reduced contractile function, and a stagnant, hazy echo within the descending aorta. Discussion: In aortic dissection, the retention of contrast agent in the false lumen of the aorta is a crucial finding for diagnosis. However, we experienced a case where contrast agent accumulated in the descending aorta, caused by low ejection fraction of the left ventricle. Differential diagnosis from aortic dissection may be possible due to the gradual decrease in contrast agent over time. This case is valuable to report given the limited number of previous reports on this phenomenon.https://escholarship.org/uc/item/76b3d8dh |
| spellingShingle | Yosuke Maezawa Kazuya Nagasaki Hiroyuki Kobayashi Shunsuke Sakai Toshiyuki Irie Contrast Agent Pooling in the Descending Aorta Due to Severe Heart Failure Clinical Practice and Cases in Emergency Medicine |
| title | Contrast Agent Pooling in the Descending Aorta Due to Severe Heart Failure |
| title_full | Contrast Agent Pooling in the Descending Aorta Due to Severe Heart Failure |
| title_fullStr | Contrast Agent Pooling in the Descending Aorta Due to Severe Heart Failure |
| title_full_unstemmed | Contrast Agent Pooling in the Descending Aorta Due to Severe Heart Failure |
| title_short | Contrast Agent Pooling in the Descending Aorta Due to Severe Heart Failure |
| title_sort | contrast agent pooling in the descending aorta due to severe heart failure |
| url | https://escholarship.org/uc/item/76b3d8dh |
| work_keys_str_mv | AT yosukemaezawa contrastagentpoolinginthedescendingaortaduetosevereheartfailure AT kazuyanagasaki contrastagentpoolinginthedescendingaortaduetosevereheartfailure AT hiroyukikobayashi contrastagentpoolinginthedescendingaortaduetosevereheartfailure AT shunsukesakai contrastagentpoolinginthedescendingaortaduetosevereheartfailure AT toshiyukiirie contrastagentpoolinginthedescendingaortaduetosevereheartfailure |