INTRAMURAL HEMATOMA OF THE AORTA CAUSED BY A PENETRATING ATHEROMATOUSULCER

Aortic dissection is a life-threatening condition which is difficult t o diagnose because of its variable clinical presentation and diverse p athophysiologic manifestations. We present a case in which intramural hematoma of the thoracic aorta occurred in the absence of an intimal f lap. Computed tomography and magnetic resonance imaging both showed he morrhage in the wall of the aorta. Transesophageal echocardiography al so revealed a penetrating atherosclerotic ulcer in the transverse aort a as a cause of the hematoma. A high index of clinical suspicion and a combination of diagnostic procedures resulted in proper diagnosis and successful surgical treatment.