RESUMO
We report a case of a 61-year-old man with aortic dissection, which was detected after mitral valve replacement. The presenting manifestation was a moderate, dull and steady pain in his right scapular region, which started on the 40th postoperative day and irradiated to the back and lower limbs. The dissection and its extent was diagnosed on transthoracic echocardiography and CT scanning and the patient improved on conservative management with beta blockers. The main purpose of reporting this case is to emphasize challenges involved with early diagnosis of this ominous condition due to nonspecific symptoms and unreliable clinical examination, and to highlight the role of the imaging studies to confirm the diagnosis of this entity.
Assuntos
Doenças da Aorta/diagnóstico , Dissecção Aórtica/diagnóstico , Implante de Prótese de Valva Cardíaca/efeitos adversos , Insuficiência da Valva Mitral/cirurgia , Dissecção Aórtica/diagnóstico por imagem , Dissecção Aórtica/etiologia , Doenças da Aorta/diagnóstico por imagem , Doenças da Aorta/etiologia , Ecocardiografia , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Fatores de TempoRESUMO
Thoracic disc herniations are commonly found in asymptomatic individuals, sometimes with genetic predisposition. Congenital fusions of cervical vertebrae occur in Klippel-Feil syndrome, which may be asymptomatic or cause compressive myelitis due to cervical instability or associated herniated discs. We report the case of a 72-year-old man with monophasic acute transverse myelitis probably caused by herpes simplex virus, coexistent with fused cervical vertebrae (C4-C5) and thoracic herniated discs. Establishment of the aetiology in cases of transverse acute myelitis can constitute a challenge in patients with cervical spine anomaly and disc herniations.