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International Conference on
FAMILY MEDICINE AND FAMILY PHYSICIANS
October 16-17, 2017 | Toronto, Canada
Arch Gen Intern Med 2017 | Volume 1 Issue 3
Type a aortic dissection: a rare sequelae of systemic lupus erythematosus
Fakhrudin A Mohamed MD, Saad Jamal MD, Robbie Olakh MSIV, Leza Naydich MSIV
and
Petham Muthuswamy MD
S
ystemic lupus erythematosus is a chronic systemic
inflammatory disease which is known to affect several
organ systems. Cardiovascular complications are a known
manifestation of the disease; however, aortic disease is
rarely exhibited. In this case report, we present the case of a
68 year old African American female with a 20-year history
of systemic lupus erythematosus on prednisone therapy,
who presented with excruciating substernal chest pain
progressively worsening over 2 days. Physical examination
revealed an irregular heartbeat with friction rub. CT lung
showed a 4.6cm dilated ascending thoracic aorta with
evidence of dissection in the proximal aorta. The patient
underwent a successful hemi-arch repair of aortic dissection.
Her condition subsequently improved after a postoperative
course that was complicated by renal insufficiency, and she
was discharged with appropriate follow-up. There have been
only a few documented cases of aortic complications related
to systemic lupus erythematosus. We reviewed and analyzed
cases of systemic lupus erythematosus diagnosedwith type A
aortic dissection that have been reported in the literature. In
its natural evolution, without treatment, acute type A aortic
dissection reportedly has a mortality rate of about 1% per
hour initially, with half of the patients expected to be dead
by the 3rd day, and almost 80% by the end of the 2nd week.
Due to the morbidity and mortality associated with type A
aortic dissection, we suggest that clinicians should harbor
a higher index of suspicion for aortic complications while
managing patients with systemic lupus erythematosus, and
develop appropriate screening and management strategies.
e:
doctor.fakhrudin@gmail.com