Aortitis masquerading as intramural hematoma: When to observe, when to operate? A case report

Ana K. Velez, Eric Etchill, Marc K. Halushka, Stefano Schena

Research output: Contribution to journalArticlepeer-review


Radiologic evidence of aortic disease is not always consistent with the diagnosis. With a lack of accompanying symptoms or with an atypical presentation, diagnosis, and management of aortic pathology rely greatly on imaging techniques. We report the case of a 58-year-old female who presented with incidental radiographic findings consistent with a type A aortic intramural hematoma and a vague left-sided chest discomfort. After follow-up, imaging was consistent with disease progression and hematoma expansion; the affected segment was resected and pathology reported lymphoplasmacytic aortitis as the underlying etiology of the imaging findings rather than an intramural hematoma. The patient lacked symptoms or serology consistent with the rheumatologic disease, and the postoperative course was uneventful. The management of a suspected ascending intramural hematoma is controversial, especially when the patient presents with atypical signs and symptoms. Features of disease progression may warrant urgent surgical intervention.

Original languageEnglish (US)
Pages (from-to)1554-1556
Number of pages3
JournalJournal of Cardiac Surgery
Issue number4
StatePublished - Apr 2021


  • Aortitis
  • aortic imaging
  • intramural hematoma

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine


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