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Patient Presentation

  • 28 year old white male with a past medical history significant for untreated hypertension
  • Presents with 3 day history of chest discomfort, lower extremity weakness, bowel and bladder dysfunction, near-syncopal episodes
  • Absent pulse in right femoral artery, weak pulse in left femoral artery
  • Echosonography showed acute Type A dissecting aortic aneurysm
  • Treatment

Immediately taken to surgery for repair of aorta with a graft and replacement of the aortic valve

  • Outcome

Unstable after surgery

Biventricular heart failure

Persistent bleeding into mediastinum due to DIC

Required massive transfusion of RBCs, FFP, Cryoprecipitate, and Platelets

Became anuric and acidotic

Became fluid overloaded à Pulmonary edema

Progressive deterioration à Multi-Organ Failure à Death

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