Master of the Masquerade: An Atypical Presentation of Acute Aortic Dissection

Mando, Ramy; Tim, Daniel; DeCicco, Anthony; Trivax, Justin; Hanson, Ivan

doi:10.1155/2020/5743985

Cited by 3 publications

(3 citation statements)

References 14 publications

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“…Symptomatology of pain is found in over 90% of patients, while the remaining 10% are painless [ 3 ]. These include signs/symptoms of heart failure, a complex effusion on CT or echocardiogram, seizure activity due to acute cerebral ischemia, or without signs/symptoms of pain [ 6 ]. Of these two groups, Type A aortic dissection occurred more frequently in the painless group [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Quiet & deadly: Painless aortic dissection

Chawla

Al-Embideen

Riordan

2023

International Journal of Cardiology Cardiovascular Risk and Pre

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Section: Discussionmentioning

confidence: 99%

Quiet & deadly: Painless aortic dissection

Chawla

Al-Embideen

Riordan

2023

International Journal of Cardiology Cardiovascular Risk and Pre

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“…Errors in misdiagnosis delay proper treatment, leading to a further risk of complications [1] . It is important for medical professionals to have a high index of suspicion for patients presenting with risk factors and atypical symptoms [3,4] . Some 40% of patients above 40 years of age do not present with the typical features and characteristics [4] .…”

Section: Case Descriptionmentioning

confidence: 99%

Painless Presentation of a Deadly Disease: Type A Aortic Dissection Requiring the Bentall Procedure

Noori

Shah

Fichadiya

et al. 2022

European Journal of Case Reports in Internal Medicine

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Aortic dissection is a relatively uncommon, although catastrophic, disease which requires early and accurate diagnosis and treatment for patient survival. Aortic dissection can be difficult to diagnose due to the diverse symptom presentation, which can lead to later diagnosis, resulting in a higher mortality rate. Here we present a case of type A aortic dissection with a varied symptom presentation, highlighting the importance of early detection and the Bentall procedure for management of such cases. A 50-year-old man with no known medical history presented with bilateral lower extremity swelling and fatigue for 2 weeks. The patient denied any chest pain or dyspnoea. Vital signs showed blood pressure of 160/76 mmHg, pulse of 103 bpm, respiratory rate of 18, and temperature of 36.7°C. Laboratory findings indicated a BNP of 1901 pg/ml and troponin of 0.5 ng/ml. An initial diagnosis of decompensated heart failure was made, and IV Lasix was started. Subsequently, an echocardiogram indicated an EF of 50–55% and ascending dissection of the aorta. A CT angiogram of the chest and abdomen confirmed this diagnosis. This patient presented with unusual symptoms of aortic dissection without the typical presentation of chest pain. It is important to consider aortic dissection in a cardiac-related case as prompt imaging can help confirm the diagnosis. We explore the risks and benefits of the Bentall procedure for the management and early detection of aortic dissection.

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“…Furthermore, for every hour that a Stanford type A AAD is left untreated, the mortality rate increases by 1%-2% per hour [3][4][5]. The most common risk factor for AAD is hypertension (76.6%), while atherosclerotic disease (27%), prior cardiac surgery (16%), and inherited tissue connective diseases (ITCD) like Marfan syndrome (5%) are other common risk factors [6,7]. Patients below 40 years of age make up a minority of patients with AAD (7%) and often possess unique risk factors like Marfan syndrome or a bicuspid aortic valve based on a study employing the International Registry of Aortic Dissection (IRAD) [8].…”

Section: Introductionmentioning

confidence: 99%

Acute Type A Aortic Dissection Confounded by Aberrant Symptoms

Anuforo¹,

Adhikari²,

Olojakpoke³

et al. 2021

Cureus

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Acute aortic dissection (AAD) is a cardiovascular emergency that requires emergent surgical, endovascular, or medical intervention depending on the portion of the aorta implicated, as dictated by the Stanford classification, and the extent of aortic involvement. Acute chest pain radiating to the back is typically seen in AAD and may be associated with radial pulse deficits. A high index of suspicion is required to diagnose and initiate management of this emergency as early as possible. This is a report of an atypical presentation of an extensive aortic dissection identified in a young man without most of the typical risk factors, but which was promptly diagnosed and treated.

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Master of the Masquerade: An Atypical Presentation of Acute Aortic Dissection

Abstract: Acute aortic dissection (AAD) is associated with unacceptably high mortality rate. As such, early diagnosis and aggressive management are essential in order to avoid life-threatening complications. Herein, we report an atypical presentation of AAD and clinical sequelae.

Cited by 3 publications

References 14 publications

Quiet & deadly: Painless aortic dissection

Quiet & deadly: Painless aortic dissection

Painless Presentation of a Deadly Disease: Type A Aortic Dissection Requiring the Bentall Procedure

Acute Type A Aortic Dissection Confounded by Aberrant Symptoms

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