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January 1958

Venous Angiocardiographic Diagnosis of Acute Dissecting Hematoma of Aorta (Dissecting Aneurysm)

AMA Arch Surg. 1958;76(1):116-122. doi:10.1001/archsurg.1958.01280190118022

Acute dissecting hematoma of the aortic wall is now potentially curable by surgery.1 Without surgery more than one-third of persons so afflicted will die within 48 hours and about two-thirds within 10 days.2 On the other hand, an exploratory operation may carry an even greater risk because of the many serious diseases which mimic this lesion clinically. What is urgently needed, therefore, is a safe procedure which can establish the diagnosis beyond question immediately after the onset of symptoms.

This paper describes three instances of acute dissecting hematoma to show that venous angiocardiography is a safe procedure which supplies a diagnostic picture. A fourth case illustrates the angiocardiographic pattern of a combination of an aneurysm of the aorta and healed dissecting hematoma.

Cases of Acute Dissecting Hematoma 

Case 1.  —A 60-year-old Negro man was admitted to Temple University Hospital on March 31, 1957, because of persistent pain, which