Document Type

Article

Publication Date

2026

Abstract

Assessing and monitoring a growing aortic root aneurysm through an echocardiogram is essential, as this can become life-threatening and lead to in-depth cardiovascular complications. Many individuals can live with an unknown aortic aneurysm due to the lack of symptoms until the pathology progresses and becomes deadly. By utilizing multimodality imaging such as; Transthoracic-Echocardiogram (TTE), Transesophageal-Echocardiogram (TEE), and Computed Tomography (CT), we can assess this pathology. This case study examines a 45-year-old male with significant cardiac history, including a dilated aortic root and mechanical aortic valve replacement, who has missed several routine follow-up echo appointments. Using the most recent imaging results, providers have confirmed a large aortic root aneurysm as well as vegetation growth on the mechanical valve, requiring life-saving surgical intervention. This patient underwent open heart surgery to repair the following but ultimately faced many intraoperative complications leading to biventricular failure. After an extended stay in the intensive care unit the patient was discharged with an ejection fraction severely reduced at 20-25%. The patient is scheduled for continued follow-up appointments to monitor cardiac function. The objective of this case study is to emphasize the importance of routine surveillance of aortic pathology. This case highlights the critical role of emergency medicine, advanced life support, including the use of Veno-Arterial extracorporeal membrane oxygenation (VA-ECMO), and demonstrates the risks associated with the lack of access to non-emergency medical transportation for monitoring appointments.

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