Acute dysphagia associated with aortic dissection: a case report and review of the literature

Perheentupa, Ulla; Kinnunen, Ilpo; Kujari, Harry; Grénman, Reidar; Mäkitie, Antti

doi:10.3109/00016480903334437

Cited by 7 publications

(6 citation statements)

References 8 publications

(18 reference statements)

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“…Symptoms have included dysphagia owing to esophageal compression [24], Horner’s syndrome resulting from pressure on the cervical sympathetic ganglion [6,7] and hoarseness caused by compression of the left recurrent laryngeal nerve [25]. In our study, one patient presented hoarseness.…”

Section: Discussionmentioning

confidence: 87%

Eleven years of experience with the neurologic complications in Korean patients with acute aortic dissection: a retrospective study

Lee

Kim

et al. 2013

BMC Neurol

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BackgroundThis study attempts to explore the clinical features, possible mechanisms and prognosis of the neurologic complications in patients with acute aortic dissection (AD).MethodsMedical records of 278 consecutive patients with AD (165 with type A and 113 with type B dissection) over 11.5 years were retrospectively analyzed for clinical history, CT findings, neurologic complications and outcome. Neurologic complications were classified into early-onset or delayed-onset complications. Independent t-test or Chi-square test (or Fisher exact test) was used for comparing the different groups. Multivariable logistic regression analysis was performed to determine the independent association between variables.ResultsThe mean age of the included patients (145 male and 133 female) was 59.4 years (range 19–91 years). 41 patients (14.7%) had a neurologic complication, which included 21 with early-onset complication and 23 with delayed-onset complication, including 3 with both. Advanced age and classic type of dissection were independently associated with the neurologic complication in patients with type A dissection. The most frequent manifestation was ischemic stroke (26 patients, 9.4%), followed by hypoxic encephalopathy (9, 3.2%), ischemic neuropathy (5, 1.8%), spinal cord ischemia (5, 1.8%), seizure (2, 0.7%), hoarseness (1, 0.4%) and septic encephalopathy (1, 0.4%). Overall in-hospital mortality was 10.1%, whereas the complicated group had a mortality rate of 43.9%. Renal impairment, pulse deficit, neurologic complication and nonsurgical treatment were independent variables for determining in-hospital mortality in patients with type A dissection.ConclusionsThe dominance of neurologic symptom in the early stage of AD may make its early diagnosis difficult. Besides chest pain and widened mediastinum in chest x-ray, variable neurologic symptoms including left hemiparesis with asymmetric pulse and hypotension may suggest underlying AD.

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Section: Discussionmentioning

confidence: 87%

Eleven years of experience with the neurologic complications in Korean patients with acute aortic dissection: a retrospective study

Lee

Kim

et al. 2013

BMC Neurol

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“…Other coexisting historical findings concerning rupture or dissection are seen in Table 1 [ 4 ]. Although not seen in this case, several recent reports have noted acute or progressive onset of dysphagia [ 5 , 6 ] or cough [ 7 ] with hoarseness at presentation. High risk physical exam findings may include a new aortic insufficiency murmur, hypotension or shock state, pulse deficits, focal neurologic deficit, or systolic blood pressure limb differential greater than 20 mmHg [ 4 ].…”

Section: Discussionmentioning

confidence: 61%

Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility

Gnagi

Howard

Hoxworth

et al. 2015

Case Reports in Otolaryngology

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Objective. To recognize intrathoracic abnormalities, including expansion or rupture of aortic aneurysms, as a source of acute onset vocal fold immobility. Methods. A case report and review of the literature. Results. An 85-year-old female with prior history of an aortic aneurysm presented to a tertiary care facility with sudden onset hoarseness. On laryngoscopy, the left vocal fold was immobile in the paramedian position. A CT scan obtained that day revealed a new, large hematoma surrounding the upper descending aortic stent graft consistent with an acute contained ruptured aortic aneurysm. She was referred to the emergency department for evaluation and treatment by vascular surgery. She was counseled regarding surgical options and ultimately decided not to pursue further treatment. Her vocal fold immobility was subsequently treated via office-based injection medialization two weeks after presentation and again 5 months after the initial injection which dramatically improved her voice. Follow-up CT scan at 8 months demonstrated a reduction of the hematoma. The left vocal cord remains immobile to date. Conclusion. Ortner's syndrome, or cardiovocal syndrome, is hoarseness secondary to left recurrent laryngeal nerve palsy caused by cardiovascular pathology. It is a rare condition and, while typically presenting gradually, may also present with acute symptomatology.

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“…The secondary cause is due to surgical repair of thoracic aortic aneurysm. [ 7 8 ] Aneurysms of the aorta can be saccular or fusiform. Saccular aneurysm carries ominous prognosis and fusiform aneurysm includes dissecting aneurysms, which are broadly classified as proximal or ascending aorta (Stanford type A) and distal or descending aorta (Stanford type B).…”

Section: Discussionmentioning

confidence: 99%

Dysphagia aortica: Emerging role of endoscopic ultrasound (with videos)

et al. 2018

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Dysphagia can occur due to extrinsic compression on esophagus. Dysphagia due to intrathoracic vascular causes is rare. Most reported cases of vascular etiology are due to dysphagia lusoria. Dysphagia due to any anomaly of aorta is called dysphagia aortica. In an emergency setting, endoscopic ultrasound (EUS) has been found to be superior and more sensitive for detection of abdominal aortic aneurysms over conventional radiological methods. We present a series of four cases of dysphagia aortica where the diagnosis was made by endoscopic ultrasound.

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Acute dysphagia associated with aortic dissection: a case report and review of the literature

Cited by 7 publications

References 8 publications

Eleven years of experience with the neurologic complications in Korean patients with acute aortic dissection: a retrospective study

Eleven years of experience with the neurologic complications in Korean patients with acute aortic dissection: a retrospective study

Acute Contained Ruptured Aortic Aneurysm Presenting as Left Vocal Fold Immobility

Dysphagia aortica: Emerging role of endoscopic ultrasound (with videos)

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