Venous Angiocardiographic Diagnosis of Acute Dissecting Hematoma of Aorta (Dissecting Aneurysm)

Abstract

Acute dissecting hematoma of the aortic wall is now potentially curable by surgery.¹ Without surgery more than one-third of persons so afflicted will die within 48 hours and about two-thirds within 10 days.² On the other hand, an exploratory operation may carry an even greater risk because of the many serious diseases which mimic this lesion clinically. What is urgently needed, therefore, is a safe procedure which can establish the diagnosis beyond question immediately after the onset of symptoms. This paper describes three instances of acute dissecting hematoma to show that venous angiocardiography is a safe procedure which supplies a diagnostic picture. A fourth case illustrates the angiocardiographic pattern of a combination of an aneurysm of the aorta and healed dissecting hematoma. Cases of Acute Dissecting Hematoma Case 1. —A 60-year-old Negro man was admitted to Temple University Hospital on March 31, 1957, because of persistent pain, which