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Case Report |

A Case of Acute Type A Aortic Dissection Complicated with High-Altitude Pulmonary Edema

We report a case of a 55-year-old middle-aged male patient who developed dyspnea while traveling in a high-altitude region. After further investigations, he was diagnosed with high-altitude pulmonary edema (HAPE). During the treatment process, he was urgently transferred to our hospital due to chest pain, and a computed tomography angiography (CTA) confirmed acute type A aortic dissection (ATAAD). The patient underwent an emergency Bentall procedure, total arch replacement, and descending aortic stent placement. The surgery was uneventful. The postoperative recovery was smooth and the patient was discharged in good condition. ATAAD is a critical condition in cardiac surgery, with a low incidence rate but an increasing trend. It is associated with high mortality rates. Acute pulmonary edema is one of the complications of aortic dissection, possibly related to acute aortic valve insufficiency and the release of inflammatory factors leading to pulmonary capillary damage. Acute pulmonary edema will seriously affect lung function, and the resulting hypoxemia will also lead to hypoxia in tissue cells of organs throughout the body, leading to disorder of the body's internal environment. HAPE refers to the patient who has recently arrived at a plateau (generally above 3,000 meters above sea level) and has difficulty breathing at rest, chest tightness, cough, white or pink foamy sputum, and the patient feels general weakness or reduced mobility. The main pathological change of high-altitude pulmonary edema is extensive alveolar edema distributed in patches, and occasionally the formation of hyaline membranes can be seen (this is caused by fibrin deposition in the alveolar edema fluid). HAPE is a non-cardiogenic pulmonary edema specific to high-altitude regions, with severe conditions and high mortality rates. The current understanding suggests that the mechanism of HAPE involves excessive elevation of pulmonary arterial pressure due to hypoxia, increased pulmonary vascular permeability, impaired pulmonary fluid clearance, fluid retention, and fluid transport imbalance. Acute pulmonary edema is a relatively rare presentation of aortic dissection, and the combination of ATAAD and HAPE is extremely rare, posing additional challenges to surgical treatment and anesthesia management.

Acute Type A Aortic Dissection, High-Altitude Pulmonary Edema, Acute Pulmonary Edema

APA Style

Song, L., Li, X. (2023). A Case of Acute Type A Aortic Dissection Complicated with High-Altitude Pulmonary Edema. Cardiology and Cardiovascular Research, 7(4), 97-100. https://doi.org/10.11648/j.ccr.20230704.16

ACS Style

Song, L.; Li, X. A Case of Acute Type A Aortic Dissection Complicated with High-Altitude Pulmonary Edema. Cardiol. Cardiovasc. Res. 2023, 7(4), 97-100. doi: 10.11648/j.ccr.20230704.16

AMA Style

Song L, Li X. A Case of Acute Type A Aortic Dissection Complicated with High-Altitude Pulmonary Edema. Cardiol Cardiovasc Res. 2023;7(4):97-100. doi: 10.11648/j.ccr.20230704.16

Copyright © 2023 Authors retain the copyright of this article.
This article is an open access article distributed under the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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