Case Report
Volume 8 Issue 7 - 2021
Incidental Penetrating Aortic Ulcer of the Ascending Aorta: Case Report
Marwa Abdul Hakeem*, Maha Bouziane, Mahamadou Charfo and Rachida Habbal
Cardiology Department, Ibn Rochd Universiy Hospital of Casablanca, Morocco
*Corresponding Author: Marwa Abdul Hakeem, Cardiology Department, Ibn Rochd Universiy Hospital of Casablanca, Morocco.
Received: May 26, 2021; Published: June 25, 2021


Penetrating aortic ulcer is part of the acute aortic syndromes; it represents 2 - 7% of this acute disease. It is frequently located in the descendant aorta; it’s rarely found in the ascending aorta. It’s generally seen in the elderly individuals who are usually poor candidates for conventional surgery due to advanced age and the presence of comorbidities. It is a unique entity, given its multiple clinical presentations, its different and unforeseeable complications, as well as the diversity of its treatment options. As a result of the development of multidetector CT scans, the detection of penetrating atherosclerotic ulcer has increased, and it is frequently identified as an incidental finding on different imaging tests.

We report a case of an incidental penetrating aortic ulcer of the ascending aorta in an asymptomatic patient admitted to the cardiology department of the university hospital of Casablanca for a hemorrhagic accident due to vitamin K antagonist. After the objection to surgery, the patient received conservative medical therapy consisting of antihypertensive therapy and beta blocker.


Keywords: Aortic Disease; Penetrating Atherosclerotic Ulcer; Ascending Aorta; Asymptomatic Penetrating Aortic Ulcer


  1. Patatas K., et al. “Penetrating atherosclerotic ulcer of the aorta: a continuing debate”. Clinical Radiology8 (2013): 753-759.
  2. Singhal P and Lin Z. “Penetrating Atheromatous Ulcer of Ascending Aorta: A Case Report and Review of Literature”. Heart, Lung and Circulation5 (2008): 380-382.
  3. Nathan DP., et al. “Presentation, complications, and natural history of penetrating atherosclerotic ulcer disease”. Journal of Vascular Surgery 55 (2012): 10-15.
  4. Coady MA., et al. “Pathologic variants of thoracic aortic dissections”. Cardiology Clinics4 (1999): 637-657.
  5. Hayashi H., et al. “Penetrating Atherosclerotic Ulcer of the Aorta: Imaging Features and Disease Concept”. Radio Graphics4 (2000): 995-1005.
  6. 2014 ESC Guidelines on the diagnosis and treatment of aortic diseases”. European Heart Journal41 (2014): 2873-2926.
  7. Murphy MC., et al. “Acute Aortic Syndromes: Diagnosis and Treatment”. Missouri Medicine6 (2017): 458-463.
  8. Troxler M., et al. “Penetrating atherosclerotic ulcers of the aorta”. British Journal of Surgery9 (2001): 1169-1177.
  9. Eggebrecht H., et al. “Intramural hematoma and penetrating ulcers: indications to endovascular treatment”. European Journal of Vascular and Endovascular Surgery 6 (2009): 659-665.
  10. Kyaw H., et al. “An uncommon cause of chest pain - penetrating atherosclerotic aortic ulcer”. Journal of Community Hospital Internal Medicine Perspectives 6.3 (2016): 31506.
  11. Cochennec F and Marzelle J. “Les syndromes aortiques aigus”. La Presse Médicale2 (2018): 140-152.
  12. Dev R., et al. “Demystifying penetrating atherosclerotic ulcer of aorta: unrealised tyrant of senile aortic changes”. Journal of Cardiovascular and Thoracic Research 1 (2021): 1-14.
  13. Salim S., et al. “The management of penetrating aortic ulcer”. Hearts 1 (2020): 5-13.
Citation: Marwa Abdul Hakeem., et al. “Incidental Penetrating Aortic Ulcer of the Ascending Aorta: Case Report”. EC Cardiology 8.7 (2021): 10-15.

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