CTICasesConcurrent Type A Aortic Dissection with Pulmonary Embolism
Imaging findings
CT angiography obtained with dual-protocol PE and aortic dissection technique demonstrates bilateral pulmonary emboli as well as a type A aortic dissection with cardiac tamponade (pericardial effusion), IVC and SVC dilation from cardiac compression, and tracking of blood around the ostia of the coronary arteries via the transverse and oblique sinuses with epicardial fat infiltration. Shared bronchoarterial sheath extension of the dissection is also identified.
Key takeaways
Simultaneous acute type A aortic dissection and pulmonary embolism is exceedingly rare but can occur. The combination carries catastrophic hemodynamic consequences. CT angiography of the thorax with both aortic and PE protocols can diagnose both entities in a single examination. Blood tracking from a type A dissection into the pericardial cavity and along the coronary artery sheaths is a life-threatening finding requiring emergent surgical intervention.
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