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Case Report: Surgical treatment of type B aortic dissection in an adult with double aortic arch

Frontiers in Cardiovascular Medicine

BackgroundDouble aortic arch (DAA) with type B aortic dissection in adults is a rare aortic vascular disease. Computed tomography angiography (CTA) indicated a double aortic arch anomaly with localized dissection of the descending aorta.

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Chest pain and a "normal" ECG

Dr. Smith's ECG Blog

This is another case written by Pendell Meyers (who is helping to edit the blog and has many great recent posts) Case A 45 year old man was driving to work when he experienced acute onset sharp left sided chest pain with paresthesias of the left arm. A repeat ECG was recorded with pain 2/10: Not much change.

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An undergraduate who is an EKG tech sees something. The computer calls it completely normal. How about the physicians?

Dr. Smith's ECG Blog

A 63 year old man with a history of hypertension, hyperlipidemia, prediabetes, and a family history of CAD developed chest pain, shortness of breath, and diaphoresis after consuming a large meal at noon. He called EMS, who arrived on scene about two hours after the onset of pain to find him hypertensive at 220 systolic.

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Persistent Chest Pain, an Elevated Troponin, and a Normal ECG. At midnight.

Dr. Smith's ECG Blog

A middle aged male presented at midnight after 14 hours of constant, severe substernal chest pain, radiating to his throat and to bilateral jaws, and associated with diaphoresis. The pain was not positional, pleuritic, or reproducible. It was not relieved by anything. He had no previous medical history.

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Chest pain with NonDiagnostic ECG but Diagnostic CT Scan

Dr. Smith's ECG Blog

An elderly woman presented with chest pain that radiated to the back for several hours. The first troponin returned at 0.099 ng/mL (elevated, consistent with Non-Occlusion MI) Providers were concerned with aortic dissection, so they order a chest aorta CT. It is essentially normal.

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Do you need to be a trained health care professional to diagnose subtle OMI on the ECG?

Dr. Smith's ECG Blog

The provider had sent the patient for an aortic dissection scan which had shown extremely heavy calcification of the LAD. The patient had continued to have chest pain. There was a 100% proximal LAD occlusion that was opened and stented. The cath lab was activated. But 45 minutes later than it should have been.

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Abnormal echocardiographic finding mimicking paracardiac cystic lesion

Heart BMJ

Previous medical interventions included a spectrum of procedures, including catheter-directed thrombectomy for popliteal artery aneurysms with thrombosis, vascular bypass grafting for cerebral-anterior communicating artery aneurysms and arch replacement and stent implantation for aortic dissecting aneurysms.