Submitted by Dr TANG Kam Shing on 15 April 2009
ICU, Tuen Mun Hospital
This M/35 had known history of chronic renal failure on dialysis and hypertension on multiple anti-hypertensives. He was admitted for confusion and was found to be hypotensive. CXR showed right sided infiltrates, cardiomegaly and widened mediastinum. Bedside echo was done and the following was noted. What is the abnormality?
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Answer: the echo showed a grossly dilated aortic root. The question of aortic dissection is raised and TEE was done, showing no intimal flap. The dilated aortic root is probably due to longstanding hypertension