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TRIGGERED BY COVID OR INEVITABLE: A CASE OF COVID RELATED AORTIC DISSECTION IN MARFAN’S SYNDROME
Abstract   Open access   Peer reviewed

TRIGGERED BY COVID OR INEVITABLE: A CASE OF COVID RELATED AORTIC DISSECTION IN MARFAN’S SYNDROME

Amjad Basheer, Madiha Rasool, Hina Amin and Stephanie Saucier
Journal of the American College of Cardiology, Vol.77(18 Suppl 1), pp.2010-2010
05/11/2021
DOI: 10.1016/S0735-1097(21)03366-0
PMCID: PMC8091220
url
https://doi.org/10.1016/S0735-1097(21)03366-0View
Published (Version of record) Open Access

Abstract

Background Aortic dissection is the most common cause of premature death in Marfan's syndrome. Case reports have linked aortic dissection to the novel coronavirus. Evidence shows an increased rate of aortic dissection during flu season. Clinical suspicion and rapid diagnosis of aortic dissection are vital for patient survival. Case A 17-year-old male with marfanoid appearance and a family history of aortic dissection presented with substernal chest pain. He was diagnosed with COVID-19 infection two weeks prior. His vitals were stable on admission with an elevated d-dimer. Computed tomography with angiography revealed Type A aortic dissection and fusiform aneurysm (8.8cm) of the ascending aorta. Decision-making The patient met clinical diagnostic criteria for Marfan syndrome. His elevated d-dimer and symptoms prompted evaluation with CTA. The decision was made for emergent surgery. A high index of suspicion for aortic dissection is crucial in patients with marfanoid features. Multimodality imaging with chest x-ray, CTA, and transesophageal imaging was used during this patient's diagnosis and treatment. Conclusion This is the first case of a patient with the novel coronavirus and Marfan's with aortic dissection. The link between aortic dissection and the novel coronavirus remains unanswered. Theories include increased sympathetic activity, immune-mediated injury, and inflammation. It is imperative to be aware of this potential complication in Marfan patients diagnosed with the COVID-19.
 Complex Clinical Cases

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