CTICasesFocal Aortic Root Dissection in Systemic Lupus Erythematosus
Imaging findings
Coronary CT angiography (CTA) reveals a large pericardial effusion with hyperattenuating fluid (representing hemopericardium) and a subtle, focal, circumferential dissection flap limited strictly to the aortic root, approaching the left coronary artery origin. There was no intramural hematoma visible on the non-contrast images.
Key takeaways
Patients with systemic lupus erythematosus (SLE) have an increased risk of aortic dissection and aneurysm formation, which may be linked to systemic hypertension or chronic vasculopathy. Aortic root-limited dissections can be highly subtle and easily overlooked on routine non-gated studies such as PE protocols, emphasizing the utility of dedicated ECG-gated coronary CTA in patients presenting with acute chest pain and hemopericardium.
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