{"pk":20340,"title":"Contrast Agent Pooling in the Descending Aorta Due to Severe Heart Failure","subtitle":null,"abstract":"<p><strong>Case presentation: </strong>An 86-year-old female presented to our emergency department with chest pain and orthopnea and was diagnosed with heart failure and ST-elevation myocardial infarction, prompting hospitalization. During hospitalization, she developed a fever. A chest and abdominal contrast-enhanced computed tomography (CT), conducted to investigate the cause of the fever, coincidentally revealed sedimentation of contrast agent in the descending aorta. To differentiate from aortic dissection, we conducted dynamic CT, and it was confirmed that the contrast agent within the aorta decreased over time. On the same day, an echocardiogram revealed a left ventricular ejection fraction of 36% with reduced contractile function, and a stagnant, hazy echo within the descending aorta.</p>\n<p><strong>Discussion: </strong>In aortic dissection, the retention of contrast agent in the false lumen of the aorta is a crucial finding for diagnosis. However, we experienced a case where contrast agent accumulated in the descending aorta, caused by low ejection fraction of the left ventricle. Differential diagnosis from aortic dissection may be possible due to the gradual decrease in contrast agent over time. This case is valuable to report given the limited number of previous reports on this phenomenon.</p>","language":"eng","license":{"name":"Creative Commons Attribution 4.0","short_name":"CC BY 4.0","text":"Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.","url":"https://creativecommons.org/licenses/by/4.0"},"keywords":[{"word":"Heart Failure"},{"word":"contrast agent pooling"},{"word":"Aortic Dissection"}],"section":"Images in Emergency Medicine","is_remote":true,"remote_url":"https://escholarship.org/uc/item/76b3d8dh","frozenauthors":[{"first_name":"Yosuke","middle_name":"","last_name":"Maezawa","name_suffix":"","institution":"Mito Kyodo General Hospital, Department of Internal Medicine, University of Tsukuba, Mito, Japan","department":""},{"first_name":"Kazuya","middle_name":"","last_name":"Nagasaki","name_suffix":"","institution":"Mito Kyodo General Hospital, Department of Internal Medicine, University of Tsukuba, Mito, Japan","department":""},{"first_name":"Hiroyuki","middle_name":"","last_name":"Kobayashi","name_suffix":"","institution":"Mito Kyodo General Hospital, Department of Internal Medicine, University of Tsukuba, Mito, Japan","department":""},{"first_name":"Shunsuke","middle_name":"","last_name":"Sakai","name_suffix":"","institution":"Mito Kyodo General Hospital, Department of Cardiology, University of Tsukuba, Mito, Japan","department":""},{"first_name":"Toshiyuki","middle_name":"","last_name":"Irie","name_suffix":"","institution":"Mito Kyodo General Hospital, Department of Radiology, University of Tsukuba, Mito, Japan","department":""}],"date_submitted":"2024-03-13T04:21:33.837000Z","date_accepted":"2024-05-15T17:56:30.248000Z","date_published":"2024-07-26T16:00:00Z","render_galley":null,"galleys":[{"label":"PDF","type":"pdf","path":"https://journalpub.escholarship.org/uciem_cpcem/article/20340/galley/30163/download/"}]}