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Introduction
Cardiac tamponade frequently complicates acute proximal aortic dissection and is one of the m ost
common causes of death from aortic dissection. Sixty percent of such patients have an early mortality. The
incidence of aortic dissection is estimated to be 5-30 cases per million people per year and most estimates
are based on autopsy findings. Risk factors of aortic dissection include; systemic hypertension (90%), cystic
medical degeneration in Marfan's Syndrome (10%) and a minority of iatrogenic aortic dissections due to
cross Clamping, cannulations or incision of the aorta.
Case report'
A 56 year old male with acute chest pain radiating to the back alortg with difficulty in breathing was
brought to a base hospital immediately but was found dead on admission. He was a teetotaler and had no
personal or family history of significant cardiovascular diseases. Autopsy revealed that he was an average
build person with xanthelasma of both lower eye lids. Dissection o f the heart revealed a
haemopericardium of approximately 500ml. Left coronary artery atherosclerosis had occluded the lumen
nearly completely. The left ventricle wall was hypertrophied with a thickness of 3cm. Further careful
dissection revealed a dissection of the proximal aorta. Except for hypertrophy, the histopathplogy of the
heart was unremarkable.
Conclusions
Since it is confined to the ascending aorta, this is a Type II aortic dissection. When rupture through
adventitia can cause hemorrhage into pericardial sac and sudden death. Absence of cystic medial
degeneration and the presence of cardiac muscle hypertrophy, the most probable cause for aortic
dissection in this Case could be hypertension.
