Pleural effusion at the onset of acute aortic dissection

Left-sided pleural effusion (PE) is one of the features of acute aortic dissection (AD). The present study was undertaken to clarify the relation between the presence of PE and the time interval from the onset of dissection, and the laterality of PE. We retrospectively studied patients with a confirmed diagnosis of acute AD who had undergone multidetector-row CT (MDCT). The presence of PE and its laterality in patients with acute AD were evaluated by MDCT. The relationship between the presence of PE and the time interval from onset to CT scan was evaluated. Twelve patients underwent MDCT within 7 hours of the onset of acute AD. PE was observed only in three patients (25%) who had undergone MDCT more than 4 hours after the onset. The average time from symptom onset to CT scan was longer in patients with PE than in those without PE (343±86 vs. 120±80 minutes; P=0.002). The laterality of PE varied among three patients. The current study reveals the incidence of PE to be 25% within 7 hours of the onset of acute AD and suggests the presence of PE to be dependent on the time interval since onset. Furthermore, we observed no patterns regarding the laterality of PE. (author)