Type A intramural hematoma in the setting of acute type B aortic dissection.

Type A intramural hematoma (IMH) is an uncommon entity, the pathophysiology of which is thought to be related to a contained hemorrhage within the medial layer of the aorta as a result of either rupture of the vasa vasorum or an atherosclerotic plaque. We present a case of type A IMH in the setting of acute type B aortic dissection with suspicion for malperfusion syndrome and discuss the treatment algorithm of this uncommon entity.