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Untreated severe obstructive sleep apnoea and development of acute aortic dissection


, : Untreated severe obstructive sleep apnoea and development of acute aortic dissection.

A 39-year-old man presented with sudden back pain and admitted. The contrast-enhanced CT showed the development of acute aortic dissection (AD) with patent false lumen. The dissection extended from just distal at the left subclavian artery to bilateral common iliac artery. The patient was treated with intensive blood pressure (BP) control with antihypertensive drugs, however he represented back pain after 31 days, and the follow-up CT scan revealed new blood flow entry in thrombosed false lumen and dilatation of descending aorta from 48 to 55 mm (figure 1). Two years before this admission, he had been evaluated for secondary hypertension and underwent sleep polygraphic study, which revealed severe obstructive sleep apnoea (OSA) with apnoea-hypopnea index (AHI): 33.8/h and the lowest percutaneous oxygen saturation: 79% (figure 2). However he had refused recommendation of the continuous positive airway pressure (CPAP) treatment. We presumed that intermittent.

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