Rupture of the Aorta Associated With Aortic Stenosis

THE ASSOCIATION of aortic stenosis with dilatation of the ascending aortia, so-called poststenotic dilatation, has been known for many years. Recently, with the report of four cases, 1 a clinical syndrome has been described in which there is the association of aortic stenosis with medionecrosis, dilatation, and dissecting aneurysm of the ascending aorta. It is the purpose of this paper to present a similar case with a discussion of the hemodynamic mechanisms involved in its pathogenesis. Report of a Case A 31-year-old well-developed white man gave no history of rheumatic fever, but was first informed that a heart murmur was present during a routine examination for summer camp at the age of 12 years. He was classified 4F in the Selective Service because of the murmur, and subsequently became active as a contractor, without limitation of activity, syncope, or chest pain. He had undergone a tonsillectomy in 1944, an appendectomy