Abstract
Aortic dissections have a vast array of clinical presentations that rarely follow traditional teachings. Dissections are rapidly fatal conditions requiring immediate diagnosis and treatment to reduce morbidity and mortality. We present a case of an acute aortic dissection presenting as abrupt onset, atraumatic leg pain with absent distal extremity pulses. The prompt use of point-of-care ultrasound detected an intimal flap within the abdominal aorta allowing immediate surgical consultation and intervention.
Highlights
The first documented case of an aortic dissection occurred in 1760 during the autopsy of King George II: “the pericardium was found distended with a quantity of coagulated blood... and in the trunk of the aorta we found a transverse fissure on its inner side.”[1]. Over 200 years later, our current understanding of acute aortic dissections is still evolving
We describe a case of an atypical presentation of an acute aortic dissection and the utility of point-of-care ultrasound (POCUS) in expediting the diagnosis and treatment
What is the major learning point? Ultrasound can be used to aid in the rapid diagnosis of acute aortic dissection but is not sufficient to rule out the disease
Summary
Aortic dissections have a vast array of clinical presentations that rarely follow traditional teachings. Dissections are rapidly fatal conditions requiring immediate diagnosis and treatment to reduce morbidity and mortality. We present a case of an acute aortic dissection presenting as abrupt onset, atraumatic leg pain with absent distal extremity pulses. The prompt use of point-of-care ultrasound detected an intimal flap within the abdominal aorta allowing immediate surgical consultation and intervention. The prompt use of point-of-care ultrasound detected an intimal flap within the abdominal aorta allowing immediate surgical consultation and intervention. [Clin Pract Cases Emerg Med. 2018;2(4):300–303.]
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