Chronic aortic dissection in the emergency department: a case report

Abstract

Chronic aortic dissection is a complex and potentially life-threatening condition characterised by separation of the aortic wall layers. It causes diagnostic difficulties especially in the emergency department (ED) setting due to its different presentations and critical need for rapid treatment. In this case report, we describe a 79-year-old man with a history of hypertension and oral anticoagulant use who presented to the ED with atypical chest pain, nausea and dyspnea. Initial complaints, medical history, clinical evaluation and imaging were suggestive of chronic aortic dissection. The patient's clinical course, diagnostic work-up in the emergency department, including computed tomography angiography (CTA), and management strategy are discussed. The diagnostic challenges and decision-making process in the emergency department are highlighted. The successful outcome in this case is to demonstrate the importance of a high index of suspicion and rapid imaging in the emergency department for patients presenting with atypical symptoms and risk factors for aortic dissection. This case report aims to highlight the critical role of emergency medicine in the early recognition and management of chronic aortic dissection. It emphasises the need for awareness and rapid action in the emergency department to improve patient outcomes in this potentially dangerous condition.