Unreliability of ASI to predict risk of aortic dissection in
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Case Report:
A 23-year-old woman with TS (45,X karyotype), Graves-Basedow disease and systemic arterial hypertension treated with ?-blockers, presented to our hospital facility because of fever unresponsive to antibiotics. She had experienced chest pain 1 mo previously which regressed spontaneously. She had no pain at hospital admission. Blood pressure was 110/82 mmHg.

The patient`s height and weight were 160 cm and 82 kg, respectively, with a body surface area of 1.85 m2. TS was diagnosed at the age of 14 years after an evaluation for short stature and delay of pubertal development. Since then, the patient underwent yearly computed tomography (CT) which showed any aortic dilatation (the diameter of the ascending aorta at the latest scan before admission was 26 mm).

A CT scan at admission revealed a contained rupture of a dissected aortic arch with two false aneurysms between the common brachial trunk (CBT) and the left carotid artery (LCA), and between the LCA and left subclavian artery (LSA) . A peri-aortic hematoma originating from the arch was present around the anterior aspect of the ascending aorta. The diameters of the aorta were =as follows: ascending aorta 26 mm, arch 30 mm and proximal descending aorta 19 mm. The ascending aortic size index was 14 mm/m2. Echocardiography confirmed the diagnosis and revealed the presence of a bicuspid aortic valve and slight valve insufficiency.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4062127/
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