A. Boutaled , M. Tabat , Y. Mekouar , G. Bennani , A. Drighil , G. Lembarki
{"title":"成人主动脉弓中断表现为顽固性高血压","authors":"A. Boutaled , M. Tabat , Y. Mekouar , G. Bennani , A. Drighil , G. Lembarki","doi":"10.1016/j.acvdsp.2023.07.048","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><p>Interrupted aortic arch<span><span> (IAA) is a rare congenital heart condition where there is a complete discontinuation between the ascending and descending aorta. The association with a patent ductus arteriosus<span> or developed arterial collateral allows survival until adulthood in extremely rare cases. Transthoracic echocardiography is helpful for the diagnosis, but the exact interruption site and collateral vessels are more accurately highlighted by computed tomography </span></span>angiography (CTA) and magnetic resonance imaging (MRI).</span></p></div><div><h3>Results/Expected results</h3><p><span>A 50 year-old-patient with a history of hypertension was admitted for severe high blood pressure. The main functional symptom that prompted his consultation was a grade II NYHA dyspnea evolving for few weeks. Physical examination found a blood pressure of 190/110</span> <!-->mmHg at the right arm, 120/70<!--> <!-->mmHg at the left arm, and 110/70<!--> <span>mmHg at lower limbs. Cardiac and pulmonary auscultation were normal. The electrocardiogram showed left ventricular hypertrophy<span><span>. Transthoracic echocardiography<span> revealed severe left ventricular hypertrophy with good left ventricular function and dilatation of the </span></span>ascending aorta measured at 47</span></span> <span><span>mm. The suprasternal notch view suggested a type B IAA. CTA confirmed the diagnosis, exhibiting an IAA located between the left carotid and left subclavian artery with an arterial collateral network emerging from descending branch of the </span>transverse cervical artery (</span><span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>Adult forms of IAA are a rare and complex manifestation of a congenital heart condition. They present significant challenges due to the severity of symptoms and high operative risk involved in treatment<span>. An accurate and timely diagnosis is essential and can be achieved through a combination of echocardiography and advanced imaging techniques such as CTA or MRI angiography. A multidisciplinary approach involving a team of specialists is crucial for optimizing the management of these patients.</span></p></div>","PeriodicalId":8140,"journal":{"name":"Archives of Cardiovascular Diseases Supplements","volume":null,"pages":null},"PeriodicalIF":18.0000,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Adult interrupted aortic arch revealed by resistant arterial hypertension\",\"authors\":\"A. Boutaled , M. Tabat , Y. Mekouar , G. Bennani , A. Drighil , G. Lembarki\",\"doi\":\"10.1016/j.acvdsp.2023.07.048\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Introduction</h3><p>Interrupted aortic arch<span><span> (IAA) is a rare congenital heart condition where there is a complete discontinuation between the ascending and descending aorta. The association with a patent ductus arteriosus<span> or developed arterial collateral allows survival until adulthood in extremely rare cases. Transthoracic echocardiography is helpful for the diagnosis, but the exact interruption site and collateral vessels are more accurately highlighted by computed tomography </span></span>angiography (CTA) and magnetic resonance imaging (MRI).</span></p></div><div><h3>Results/Expected results</h3><p><span>A 50 year-old-patient with a history of hypertension was admitted for severe high blood pressure. The main functional symptom that prompted his consultation was a grade II NYHA dyspnea evolving for few weeks. Physical examination found a blood pressure of 190/110</span> <!-->mmHg at the right arm, 120/70<!--> <!-->mmHg at the left arm, and 110/70<!--> <span>mmHg at lower limbs. Cardiac and pulmonary auscultation were normal. The electrocardiogram showed left ventricular hypertrophy<span><span>. Transthoracic echocardiography<span> revealed severe left ventricular hypertrophy with good left ventricular function and dilatation of the </span></span>ascending aorta measured at 47</span></span> <span><span>mm. The suprasternal notch view suggested a type B IAA. CTA confirmed the diagnosis, exhibiting an IAA located between the left carotid and left subclavian artery with an arterial collateral network emerging from descending branch of the </span>transverse cervical artery (</span><span>Figure 1</span>).</p></div><div><h3>Conclusion/Perspectives</h3><p>Adult forms of IAA are a rare and complex manifestation of a congenital heart condition. They present significant challenges due to the severity of symptoms and high operative risk involved in treatment<span>. An accurate and timely diagnosis is essential and can be achieved through a combination of echocardiography and advanced imaging techniques such as CTA or MRI angiography. A multidisciplinary approach involving a team of specialists is crucial for optimizing the management of these patients.</span></p></div>\",\"PeriodicalId\":8140,\"journal\":{\"name\":\"Archives of Cardiovascular Diseases Supplements\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":18.0000,\"publicationDate\":\"2023-09-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Archives of Cardiovascular Diseases Supplements\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S1878648023002690\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q4\",\"JCRName\":\"Medicine\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Archives of Cardiovascular Diseases Supplements","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S1878648023002690","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"Medicine","Score":null,"Total":0}
Adult interrupted aortic arch revealed by resistant arterial hypertension
Introduction
Interrupted aortic arch (IAA) is a rare congenital heart condition where there is a complete discontinuation between the ascending and descending aorta. The association with a patent ductus arteriosus or developed arterial collateral allows survival until adulthood in extremely rare cases. Transthoracic echocardiography is helpful for the diagnosis, but the exact interruption site and collateral vessels are more accurately highlighted by computed tomography angiography (CTA) and magnetic resonance imaging (MRI).
Results/Expected results
A 50 year-old-patient with a history of hypertension was admitted for severe high blood pressure. The main functional symptom that prompted his consultation was a grade II NYHA dyspnea evolving for few weeks. Physical examination found a blood pressure of 190/110 mmHg at the right arm, 120/70 mmHg at the left arm, and 110/70 mmHg at lower limbs. Cardiac and pulmonary auscultation were normal. The electrocardiogram showed left ventricular hypertrophy. Transthoracic echocardiography revealed severe left ventricular hypertrophy with good left ventricular function and dilatation of the ascending aorta measured at 47mm. The suprasternal notch view suggested a type B IAA. CTA confirmed the diagnosis, exhibiting an IAA located between the left carotid and left subclavian artery with an arterial collateral network emerging from descending branch of the transverse cervical artery (Figure 1).
Conclusion/Perspectives
Adult forms of IAA are a rare and complex manifestation of a congenital heart condition. They present significant challenges due to the severity of symptoms and high operative risk involved in treatment. An accurate and timely diagnosis is essential and can be achieved through a combination of echocardiography and advanced imaging techniques such as CTA or MRI angiography. A multidisciplinary approach involving a team of specialists is crucial for optimizing the management of these patients.
期刊介绍:
Archives of Cardiovascular Diseases Supplements is the official journal of the French Society of Cardiology. The journal publishes original peer-reviewed clinical and research articles, epidemiological studies, new methodological clinical approaches, review articles, editorials, and Images in cardiovascular medicine. The topics covered include coronary artery and valve diseases, interventional and pediatric cardiology, cardiovascular surgery, cardiomyopathy and heart failure, arrhythmias and stimulation, cardiovascular imaging, vascular medicine and hypertension, epidemiology and risk factors, and large multicenter studies. Additionally, Archives of Cardiovascular Diseases also publishes abstracts of papers presented at the annual sessions of the Journées Européennes de la Société Française de Cardiologie and the guidelines edited by the French Society of Cardiology.