To correlate findings of chest radiograph with those of CT scan in aortic dissection.

We retrospectively analyzed findings of chest radiograph and CT scan of 10 aortic dissection patients(for men and six women ; aged 51-79 years old(mean 64 years)) and correlate findings of chest radiograph with those of CT scan.

Chest radiograph showed abnormal findings in nine cases(90%) with widening of wuperior mediastinum in nine(90%), disparity in size of ascending and descending aorta in four (40%), change in aortic configuration between successive examination in three (30%), bilateral pleural effusion in one(10%), and cardiomegaly in five(50%). CT scan showed atherosclerotic effusion in two(20%), pericardial effusion in one(10%), and mediastinal hematoma in two(20%). All patients with widening of superior mediastinum on chest radiograph showed aneurysm of ascending aorta and/or aortic arch on CT scan.

Chest radiograph is usually abnormal and the most common finding is wdening of superior mediastinum caused by aneurysm of ascending aorta and/or aortic arch. But normal chest radiograph may be observed in aortic dissection with mild degree aneurysm

An elevated serum lipoprotein(a) level is an independent risk factor for atherosclerotic diseases, and the lipoprotein(a) level is correlated to preclinical atherosclerosis. To evaluate the association between lipoprotein(a) and aortic selerosis, mitral sclerosis, and abdominal aorta thickness, we measured the aortic valve thickness, mitral valve thickness and abdominal aorta thickness. Also, we assessed the relationship between the aortic valve sclerosis, mitral valve sclerosis, abdominal aorta thickness and other coronary risk factors.

We measured serum lipoprotein(a) in 116 patients(52 men, 64 women) with mean age of 58.7±13.9 years. Aortic valve thickness was assessed by parasternal long and short axis two dimensional echocardiography, mitral valve thickness was measured by apical 4 chamber view. The abdominal aorta thickness was measured by the subcostal view.

The level of lipoprotein(a) was significantly correlated with the aortic valve thickness, but not with the miral valve thickness and the abdominal aorta thickness. lipoprotein(a) level was higher in smoking patients(p<0.05), and not related to other ariables such as blood pressure, age, total cholesterol, triglyceride, high density lipoprotein and low density lipoprotein. Coronary angiography was performed in 18 paitents, and there was a tendency of the coronary artery disease with high level of the lipoprotein(a)(p<0.005). There was no significant difference in the thickness of aortic valve in terms of sex, blood pressure, total cholesterol, high density lipoprotein, triglyceride or blodo sugar.

We conclude that increased serum levels of lipoprotein(a) are closely related to aortic valve sclerosis and may be a risk factor for coronary artery disease.