Effect of CPAP on acute aortic dissection with recanalisation

Description

A man aged 55 years presented to the emergency room with acute back pain. Contrast-enhanced CT revealed thrombosed-type acute aortic dissection (AD) from the distal aortic arch to the level of the renal arteries. The patient was admitted to our intensive care unit, and continuous infusion of nicardipine and propranolol was started; this infusion was titrated to maintain blood pressure below 120/80 mm Hg. Although blood pressure was well controlled for 1-week as shown by the 24-hour blood pressure monitoring results (figure 1), the follow-up CT scans showed progression for three consecutive weeks (figure 2A–C). Since the blood pressure showed a non-dipping pattern during sleep (figure 1), we suspected that the patient had sleep apnoea (SA).1

Figure 1

Blood pressure monitoring for 24 hours. Blood pressure was strictly controlled throughout the day and the night, but showed a non-dipping pattern during...

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