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European Journal of Echocardiography 2008 9(1):56-57; doi:10.1016/j.euje.2006.08.013
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2006. For permissions please email: journals.permissions@oxfordjournals.org.

Aortic intramural haematoma and chronic anticoagulation: role of transoesophageal echocardiography

Alberto Ruggiero2,3,4, Teresa González-Alujas1, José Rodríguez1, Eduardo Bossone2,3,4 and Arturo Evangelista1,*

1 Servei de Cardiologia, Hospital Universitari Vall dHebron, P° Vall dHebron 119, 08035 Barcelona, Spain
2 Divison of Cardiology and Internal Medicine, Cava de Tirreni and Amalfi Coast Hospital ASL Salerno 1, Italy
3 Clinical Physiology Institute, National Research Council of Italy (IFC–CNR), Lecce, Italy
4 Department of Clinical and Experimental Medicine, Federico II University School of Medicine, Naples, Italy

Received 6 May 2006; accepted after revision 29 August 2007; online publish-ahead-of-print 13 October 2006.

* Corresponding author. Tel: +34 93 2746212; fax: +34 93 2746244. E-mail address: aevangel{at}vhebron.net


  Abstract

The case of a 66-year-old patient with acute intramural haematoma in descending aorta, receiving anticoagulant treatment with warfarin for chronic atrial fibrillation, is presented. Transoesophageal echocardiography was fundamental in the diagnosis of the intramural haematoma, assessment of the cardioembolic risk of atrial fibrillation and in follow-up the evolution of the intramural haematoma, which facilitated therapeutic management. Although no established recommendation exists on anticoagulation in aortic intramural haematoma, individual risk-benefit assessment of anticoagulation and follow-up with imaging techniques are essential to elect the most appropriate therapeutic management.

Keywords: Transoesophageal echocardiography; Aortic intramural haematoma; Anticoagulation


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