The juvenile acute aortic dissection which caused sudden death: a case report

  • Maeda Daigen
    Department of Critical Care Medical Center, Shizuoka Saiseikai General Hospital
  • Yonemori Terutake
    Department of Critical Care Medical Center, Shizuoka Saiseikai General Hospital
  • Higashioka Hiroaki
    Department of Critical Care Medical Center, Shizuoka Saiseikai General Hospital

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  • 突然死を来した若年発症急性大動脈解離の1例

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Acute aortic dissection can lead to sudden death. We present the clinical course of a 16-year-old male whose mother had been surgically treated for acute aortic dissection. He experienced sudden back pain and was examined at a clinic. Three days later, he developed sudden convulsive seizures while taking a bath and lapsed into cardio-pulmonary arrest. He was transported to our hospital by ambulance. Chest roentogenography revealed a massive right-sided hemothorax and chest drainage was thus initiated. We continued aggressive resuscitation, but there was no return of spontaneous circulation. The same day, we performed autopsy imaging and pathological anatomic evaluations. We found an aortic dissection, approximately 20 cm in length, on the tail side from the bifurcation of the left subclavian artery, and massive hemothorax was confirmed in the right cavumthoracis. The tunica media of the aorta showed cystic medial necrosis on histological examination. Acute aortic dissection at a young age is often associated with congenital diseases such as Marfan's syndrome. However, no sign of any congenital disease was detected in this case. When an aortic dissection develops in one family member, periodic follow-up of blood relatives is considered to be very important.

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