Subacute aortic dissection presenting as heart failure due to aortic valve insufficiency and right coronary artery dissection.
Hediyeh Vaseli, Rosalind Groenewoud, Edward Percy et al.
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Case in brief
A patient with subacute thoracic aortic aneurysm dissection presented with progressive dyspnoea due to severe aortic regurgitation, leading to congestive heart failure and reduced left ventricular ejection fraction. Diagnosis was confirmed via CT angiography, and surgical repair was performed using the Hemi-Yacoub technique. Postoperatively, the patient experienced paroxysmal atrial fibrillation requiring pacemaker implantation, but showed recovery of left ventricular ejection fraction to 50% at six months.
Diagnostic / clinical pearl
Clinicians should consider aortic dissection in patients presenting with heart failure of unclear origin, especially if there are signs of significant aortic regurgitation.