Atypical Presentation of Aortic Dissection: A Case Report

Soraya Shamizadeh,Golamreza Faridaalaee

doi:10.34172/ddj.2021.24

Abstract

Background: Aortic dissection (AD) is considered to be one of the life-threatening diseases. Quick diagnosis has great significance so that a one-hour delay in treatment leads to a 1-2% increase in mortality. Case Report: The 55-year old obese woman with epigastric pain and right upper quadrant pain referred to the emergency department of our hospital. The acute coronary syndrome was our initial diagnosis but an image similar to a Perl in one cut and a crescent in another cut of computed tomography (CT) drew our attention in the mediastinal view of CT without intravenous contrast that was performed to rule out coronavirus disease-19 (COVID-19). Finally, CT-angiography was requested and AD diagnosis was approved accordingly. Conclusion: The presence of calcification on a non-contrast chest CT in the middle of the aorta or away from the artery wall can be a sign of AD. Thus, special attention should be paid to the atypical symptoms of AD.

Highlights

In Stanford type A, cardiac signs occur as the coronary arteries are involved, and it occasionally leads to myocardial infarction (MI) [4]
The radiologic manifestations of Aortic dissection (AD) in computed tomography (CT)- angiography are observed as a split between the intima and medial layers of the aorta and the formation of the lumen [5]
Case Presentation The 55-year old obese woman with epigastric pain and right upper quadrant (RUQ) pain referred to the emergency at 6:30 am

Summary

Introduction

Aortic dissection (AD) is considered to be one of the emergency and life-threatening cardiovascular diseases, and its quick diagnosis has great significance so that a one-hour delay in treatment causes a 1-2% increase in mortality [1]. In Stanford aortic classification, if the ascending aorta is involved, it is considered to be type A, otherwise, it is of type B. Syncope, neurologic signs are observed in less than 50% of Stanford type A cases. In Stanford type A, cardiac signs occur as the coronary arteries are involved, and it occasionally leads to MI [4].

Results

Conclusion