Aortic Dissection: An Easily Missed Diagnosis when Pain Doesn’t Hold the Stage

Abstract

Case seriesPatients: Male, 73-year-old • Female, 70-year-oldFinal Diagnosis: Aortic dissectionSymptoms: ParesisMedication: —Clinical Procedure: —Specialty: NeurologyObjective:Challenging differential diagnosisBackground:Type A aortic dissection (AD) is a rare disease, with a high mortality rate. Its most common symptom is thoracic pain, which is nevertheless absent in about 6% of cases. Neurologic complications are extremely rare and include ischemic stroke and ischemic neuropathy (which are the most common as presenting symptoms), spinal cord ischemia, and hypoxic encephalopathy. These rare neurological presentations can often be missed at initial clinical examination.Case Report:We report 2 cases of patients presenting with seemingly mild neurological symptoms. However, diagnostic tests revealed acute type A AD, and further steps were taken.Conclusions:Although it is a rare cause of transient stroke or peripheral nerve ischemia, AD should be quickly recognized as a potential cause of new-onset neurological manifestations.

Applying multi-omics techniques to the discovery of biomarkers for acute aortic dissection

“…However, because the symptoms are not diagnostically specific, they are easily confused with other diseases such as acute coronary syndrome (ACS), acute myocardial infarction (AMI), and acute abdomen. And in about 6% of cases, no symptoms of chest pain are present ( 20 ), making AAD often misdiagnosed or missed ( 21 ). AAD rupture can have serious side effects, including extensive bleeding that quickly results in inadequate perfusion of several organs and eventual death ( 22 ).…”

Preoperative hematological parameters are inadequate for predicting mortality in Stanford Type A aortic dissection repair

“…Acute aortic dissection (AAD) is a life-threatening disease that requires rapid diagnosis and is seen in 0.3% of patients who present to the emergency department with chest pain [1,2] . As a result of the tear between the intima and media layers of the aorta, restricted or progressing along the entire aorta, it may cause symptoms of all organ systems [3,4] .…”