Pathogenesis in acute aortic syndromes: aortic dissection, intramural hematoma, and penetrating atherosclerotic aortic ulcer.

Aortic intramural haematoma: remarks and conclusions.

A ortic intramural haematoma (IMH) originates from spontaneous rupture of the aorta vasavasorum or from a penetrating atherosclerotic ulcer. Recent advances in imaging techniques have significantly aided its diagnosis, placing the incidence between 10–30% of acute aortic syndromes. Clinical presentation may be identical to that of classical dissection. IMH affects patients with more atheroscler...

Acute Aortic Syndrome Presents with Chest Pain

Acute aortic syndrome can be due to acute aortic dissection, intramural hematoma, penetrating atherosclerotic ulcer, or unstable thoracic aneurysm. These life-threatening conditions are clinically indistinguishable, often presenting with acute chest pain. Contrast-enhanced, cardiac-gated multidetector computed tomography (CT) is a highly accurate imaging method for determining the cause of acut...

Epidemiology of Thoracic Aortic Aneurysms, Aortic Dissection, Intramural Hematoma, and Penetrating Atherosclerotic Ulcers

Intramural hematoma in acute aortic syndrome: more than one variant of dissection?

Intramural hematoma (IMH) of the aorta came onto the clinical horizon with its recognition as a variant of aortic dissection and with the early diagnostic use of modern tomographic imaging modalities in the evaluation of acute thoracic pain syndromes. IMH, which is a precursor of dissection, cannot be reliably distinguished from classic dissection on clinical grounds and is considered to repres...

Penetrating atherosclerotic ulcer of the thoracic aorta: diagnosis and treatment.

P enetrating atherosclerotic ulcer (PAU) of the thoracic aorta was first described by Shennan in 1934.1 PAU is part of acute aortic syndrome, so care must be taken concerning its diagnosis and treatment. Atherosclerotic plaques may ulcerate and erode through the internal elastic lamina into the aortic media, resulting in a PAU.2,3 Besides typical aortic dissection, the causes of acute aortic sy...