Spontaneous peri‐aortic hematoma in a patient with new‐onset chest pain

Abstract Peri‐aortic hematoma formation is a common sequela of esophageal rupture and aortic dissection, but non‐traumatic spontaneous hematoma formation is an uncommon finding. We present the case of a spontaneous peri‐aortic hematoma in a 66‐year‐old male with associated left atrial thrombus. This...

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Main Authors: Harold Gomez Acevedo, Stanley Budzinski, Micaela Ramsey
Format: Article
Language:English
Published: Elsevier 2023-04-01
Series:Journal of the American College of Emergency Physicians Open
Subjects:
Online Access:https://doi.org/10.1002/emp2.12910
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author Harold Gomez Acevedo
Stanley Budzinski
Micaela Ramsey
author_facet Harold Gomez Acevedo
Stanley Budzinski
Micaela Ramsey
author_sort Harold Gomez Acevedo
collection DOAJ
description Abstract Peri‐aortic hematoma formation is a common sequela of esophageal rupture and aortic dissection, but non‐traumatic spontaneous hematoma formation is an uncommon finding. We present the case of a spontaneous peri‐aortic hematoma in a 66‐year‐old male with associated left atrial thrombus. This 66‐year‐old male presented to a local emergency department with non‐radiating epigastric and mid‐sternal chest pain and was found to have a non‐traumatic peri‐aortic hematoma of unknown etiology that developed over a period of 12 hours. Imaging revealed a newly formed left atrial thrombus causing mass effect on the pulmonary veins and a newly formed left‐sided pleural effusion. The patient was subsequently transferred to an outside facility for higher level of care where additional pathological etiologies of hematoma were further excluded. Before discharge, the hematoma spontaneously dissipated and the patient was discharged on oral anticoagulants for treatment of the atrial thrombus and advised to follow‐up on an outpatient basis with hematology and cardiology specialists.
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spelling doaj-art-6e569c7a16bb48458971dba0bcb83d622025-08-20T03:18:22ZengElsevierJournal of the American College of Emergency Physicians Open2688-11522023-04-0142n/an/a10.1002/emp2.12910Spontaneous peri‐aortic hematoma in a patient with new‐onset chest painHarold Gomez Acevedo0Stanley Budzinski1Micaela Ramsey2HCA West Florida DivisionHCA Florida Brandon Hospital Department of Emergency Medicine BrandonFloridaUSAHCA West Florida DivisionHCA Florida Brandon Hospital Department of Emergency Medicine BrandonFloridaUSAHCA West Florida DivisionHCA Florida Brandon Hospital Department of Emergency Medicine BrandonFloridaUSAAbstract Peri‐aortic hematoma formation is a common sequela of esophageal rupture and aortic dissection, but non‐traumatic spontaneous hematoma formation is an uncommon finding. We present the case of a spontaneous peri‐aortic hematoma in a 66‐year‐old male with associated left atrial thrombus. This 66‐year‐old male presented to a local emergency department with non‐radiating epigastric and mid‐sternal chest pain and was found to have a non‐traumatic peri‐aortic hematoma of unknown etiology that developed over a period of 12 hours. Imaging revealed a newly formed left atrial thrombus causing mass effect on the pulmonary veins and a newly formed left‐sided pleural effusion. The patient was subsequently transferred to an outside facility for higher level of care where additional pathological etiologies of hematoma were further excluded. Before discharge, the hematoma spontaneously dissipated and the patient was discharged on oral anticoagulants for treatment of the atrial thrombus and advised to follow‐up on an outpatient basis with hematology and cardiology specialists.https://doi.org/10.1002/emp2.12910hematomaperi‐aorticposterior mediastinumthrombus
spellingShingle Harold Gomez Acevedo
Stanley Budzinski
Micaela Ramsey
Spontaneous peri‐aortic hematoma in a patient with new‐onset chest pain
Journal of the American College of Emergency Physicians Open
hematoma
peri‐aortic
posterior mediastinum
thrombus
title Spontaneous peri‐aortic hematoma in a patient with new‐onset chest pain
title_full Spontaneous peri‐aortic hematoma in a patient with new‐onset chest pain
title_fullStr Spontaneous peri‐aortic hematoma in a patient with new‐onset chest pain
title_full_unstemmed Spontaneous peri‐aortic hematoma in a patient with new‐onset chest pain
title_short Spontaneous peri‐aortic hematoma in a patient with new‐onset chest pain
title_sort spontaneous peri aortic hematoma in a patient with new onset chest pain
topic hematoma
peri‐aortic
posterior mediastinum
thrombus
url https://doi.org/10.1002/emp2.12910
work_keys_str_mv AT haroldgomezacevedo spontaneousperiaortichematomainapatientwithnewonsetchestpain
AT stanleybudzinski spontaneousperiaortichematomainapatientwithnewonsetchestpain
AT micaelaramsey spontaneousperiaortichematomainapatientwithnewonsetchestpain