Aortic dissection with fistula to right atrium. Noninvasive diagnosis by two-dimensional and Doppler echocardiography with successful repair. Case report and review of the literature
Hurley, D.V.; Nishimura, R.A.; Schaff, H.V.; Edwards, W.D.
Journal of Thoracic and Cardiovascular Surgery 92(5): 953-957
1986
ISSN/ISBN: 0022-5223 PMID: 3773552 Document Number: 279387
Aortic dissection with rupture into the right atrium is rare, and a high index of suspicion is required for its clinical recognition. The diagnosis should be considered in a patient with chest pain or dyspnea who at presentation has a widened pulse pressure, a continuous murmur, and evidence of right ventricular volume overload, especially when there is a history of a previous cardiac operation. Two-dimensional and Doppler echocardiography can establish the diagnosis and permit early surgical repair of the dissection and fistula.