{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T06:12:17Z","timestamp":1788502337050,"version":"build-2803163510"},"reference-count":10,"publisher":"BMJ","issue":"9","funder":[{"DOI":"10.13039\/501100008002","name":"Vancouver Coastal Health Research Institute","doi-asserted-by":"publisher","award":["Clinician Scientist Award"],"award-info":[{"award-number":["Clinician Scientist Award"]}],"id":[{"id":"10.13039\/501100008002","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004411","name":"Heart and Stroke Foundation of Canada","doi-asserted-by":"publisher","award":["New Investigator Award"],"award-info":[{"award-number":["New Investigator Award"]}],"id":[{"id":"10.13039\/100004411","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,8,25]]},"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:p>Subacute thoracic aortic aneurysm dissection (TAAD) often presents with a clinical profile distinct from its acute form, which can closely mimic common cardiac conditions, risking diagnostic delay. We report a case of subacute TAAD presenting initially with progressive dyspnoea due to severe aortic regurgitation (AR), culminating in congestive heart failure with reduced left ventricular ejection fraction. Diagnosis was confirmed with CT angiography. Surgical repair was performed using the Hemi-Yacoub technique. The postoperative course was complicated by paroxysmal atrial fibrillation, which necessitated pacemaker implantation. At the 6-month follow-up, the patient demonstrates recovery of left ventricular ejection fraction to 50%. This case highlights the importance of considering aortic pathology in patients with heart failure of unclear origin, particularly when accompanied by a new diastolic murmur or echocardiographic evidence of significant AR.<\/jats:p>","DOI":"10.1136\/bcr-2026-272319","type":"journal-article","created":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:25:21Z","timestamp":1788499521000},"page":"e272319","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Subacute aortic dissection presenting as heart failure due to aortic valve insufficiency and right coronary artery dissection"],"prefix":"10.1136","volume":"19","author":[{"given":"Hediyeh","family":"Vaseli","sequence":"first","affiliation":[{"name":"The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rosalind","family":"Groenewoud","sequence":"additional","affiliation":[{"name":"The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Percy","sequence":"additional","affiliation":[{"name":"The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7514-6069","authenticated-orcid":false,"given":"Christina","family":"Luong","sequence":"additional","affiliation":[{"name":"Division of Cardiology, The University of British Columbia Faculty of Medicine, Vancouver, British Columbia, Canada"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2026,9,2]]},"reference":[{"key":"2026090322251620000_19.9.e272319.1","doi-asserted-by":"crossref","DOI":"10.1093\/ejcts\/ezad426","article-title":"EACTS\/STS Guidelines for diagnosing and treating acute and chronic syndromes of the aortic organ","volume":"65","author":"Czerny","year":"2024","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026090322251620000_19.9.e272319.2","article-title":"Chronic Type A Aortic Dissection: Rare Presentation of Incidental Pericardial Effusion","volume":"2019","author":"Abugroun","year":"2019","journal-title":"Case Rep Cardiol"},{"key":"2026090322251620000_19.9.e272319.3","first-page":"388","article-title":"Subacute\/chronic type A aortic dissection: a retrospective cohort study","volume":"57","author":"Wu","year":"2020","journal-title":"Eur J Cardiothorac Surg"},{"key":"2026090322251620000_19.9.e272319.4","doi-asserted-by":"publisher","DOI":"10.1016\/j.athoracsur.2014.07.032"},{"key":"2026090322251620000_19.9.e272319.5","article-title":"A Case of Chronic Aortic Dissection With Hemopericardium and Tamponade","volume":"14","author":"Pavlou","year":"2022","journal-title":"Cureus"},{"key":"2026090322251620000_19.9.e272319.6","doi-asserted-by":"crossref","DOI":"10.1016\/j.jaccas.2024.102249","article-title":"Giant Aortic Root Thrombus in a Chronic, Asymptomatic Stanford Type A Aortic Dissection","volume":"29","author":"Baquero","year":"2024","journal-title":"JACC Case Rep"},{"key":"2026090322251620000_19.9.e272319.7","doi-asserted-by":"crossref","first-page":"244","DOI":"10.17161\/kjm.v13i.14634","article-title":"Asymptomatic, Chronic Type-A Dissection of a Large Ascending Thoracic Aortic Aneurysm in a Young Patient","volume":"13","author":"Tung","year":"2020","journal-title":"Kans J Med"},{"key":"2026090322251620000_19.9.e272319.8","unstructured":"Ikeda S , Saunders PC , Youdelman BA . Subacute Type A Aortic Dissection with 10% of Ejection Fraction. Clin Surg 2019;4."},{"key":"2026090322251620000_19.9.e272319.9","doi-asserted-by":"crossref","first-page":"422","DOI":"10.1016\/j.jtcvs.2021.09.034","article-title":"Long-term outcomes after aortic root repair using selective sinus replacement","volume":"166","author":"Urbanski","year":"2023","journal-title":"J Thorac Cardiovasc Surg"},{"key":"2026090322251620000_19.9.e272319.10","doi-asserted-by":"publisher","DOI":"10.1093\/ejcts\/ezt647"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2026-272319","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T05:25:22Z","timestamp":1788499522000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2026-272319"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,9]]},"references-count":10,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2026,9,2]]},"published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1136\/bcr-2026-272319"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2026-272319","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9]]}}}