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Srpski arhiv za celokupno lekarstvo
2016, vol. 144, iss. 5-6, pp. 320-324
article language: English
document type: Case Report
doi:10.2298/SARH1606320J


Acute renal failure and hepatocellular damage as presenting symptoms of type II aortic dissection
aClinical Center of Serbia, Clinic for Cardiology, Belgrade
bClinical Center of Serbia, Clinic for Cardiology, Belgrade + University of Belgrade, School of Medicine, Belgrade
cClinical Center of Serbia, Centre for Radiology and Magnetic Resonance, Belgrade
dClinical Center of Serbia, Center for Anesthesiology and Reanimatology, Belgrade

e-mail: ivana170679@gmail.com

Abstract

Introduction: Pericardial effusion can be a consequence of a number of pathological conditions, and as such it can cause impaired left ventricular filling followed by decreased cardiac output and blood pressure. This kind of hemodynamic compromise and its consequences are extremely uncommon unless pericardial effusion causes tamponade. Case Outline We describe a very rare case of a 30-year old male patient, with an acute aortic dissection type II causing pericardial effusion without clinical nor echocardiographic signs of tamponade, while presenting with an acute renal and hepatic failure. After initial diagnostic uncertainties, and following final diagnosis of an acute aortic dissection, this patient underwent surgical aortic valve replacement with a satisfactory outcome. Conclusion It is important to underscore the significance of clinical situation of simultaneously existing acute renal and hepatic failures in the setting of a 'non-tamponade' pericardial effusion, following a type II aortic dissection. Although most commonly aortic dissection presents itself with typical clinical symptoms or patient history data, it is not that unusual for it to be hidden in an entirely atypical clinical milieu as the one described in this case.

Keywords

aortic dissection; intimal flap; renal failure; hepatic failure; pericardial effusion

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