Deep vein thrombosis and pulmonary embolism in a patient with acute type B aortic dissection: a case report

Abstract

Acute dissection involving ascending aorta contains high risk of mortality and requires surgical treatmentimmediately. Venous thrombosis can manifested as deep vein thrombosis or pulmonary embolism. It may beisolated or complication of another disease. Because of pulmonary thromboembolism risk, treatment of deepvein thrombosis is strongly recommended. A 61-year-old male patient with severe back pain and shortness ofbreath presented to the emergency service. The findings of the physical examinations, chest x-ray andelectrocardiogram were normal. Contrast-enhanced computerized tomography showed an aortic intimal tearthat started just below the subclavian artery and extended into the iliac arteries. The patient was hospitalizedand the medical treatment started. On the 4th day of clinical follow-up, pain and swelling started at his right legwith severe shortness of breath. Venous Doppler ultrasound was performed and there were thrombosis atpopliteal, femoral and even at iliac veins. Computed tomography showed pulmonary embolism at pulmonarytrunk. Aortic dissection treated with endovascular stent graft firstly to prevent aortic rupture because ofanticoagulation and then pulmonary embolism treated with anticoagulant drugs. Hypercoagulation is a selfdefence of the body for limiting the aortic intimal tear to prevent aortic rupture. So many complications couldbe seen because of this situation and the physicians should be awaken for this.