Painless aortic dissection with slurred speech (Neurologic symptom)

Esmaeal Rayat Dost,Navid Kalini,Saeed Barazandehpour,Samaneh Abiri

doi:10.34172/jept.2020.18

Abstract

Objective: Aortic dissection is an uncommon disorder with a high mortality rate, especially if misdiagnosis and mistreatment are not considered. Case Presentation: We present a 67-year old female with slurred speech and left sided plegia during her brother’s funeral. The patient did not have any chest pain. she was referred to our emergency department by EMS due to being suspicious of cerebrovascular accident (CVA) )as code 724). However, owing to low blood pressure and atypical symptoms of the patient, we did RUSH exam in the emergency department to detect aortic dissection. After doing the Computed tomography (CT) angiography, the diagnosis of aortic dissection was confirmed. As the vascular surgeon was not present in our surgery department, we transferred the patient to Namazi hospital by air ambulance to undergo the surgery. She was discharged from hospital with complete recovery.Conclusion: Aortic dissection symptoms can be manifested in different ways such as pulmonary embolism, ACS, and CVA. Therefore, clinicians must always have the differential diagnosis of aortic dissection in their mind and be aware of its various manifestations.

Highlights

Aortic dissection is an uncommon disorder with a high mortality rate, especially if misdiagnosis and mistreatment are not considered
Case Presentation We present a 67-year old female who arrived at the emergency department of Peymanieh hospital due to decreased level of consciousness in her brother’s funeral
Pipe exam results were in favor of abdominal aortic dissection with aorta diameter of 3 centimeters

Summary

Introduction

Aortic dissection is known to be an uncommon and serious disease in which the inner layers of aorta or other large vessels originating from heart tear [1]. The patient did not mention any positive history related to aortic dissection. Her past medical history revealed hypertension, and the patient took losartan 25 mg twice daily. Her vital signs were: blood pressure 80/60 in her both arms with a pulse rate of 70/min, respiratory rate was 18/min with a temperature of 37 axillary. Due to blood pressure of 80/60 and pulse rate of 70, she did not need any hypertensive medication We referred her to thoracic surgery department of Namazi hospital of Shiraz University of Medical Sciences by air ambulance. She was discharged within 30 days after the operation (Figure 1)

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Discussion

Conclusion