Primary Hyperaldosteronism: A Rare Potential Risk Factor for Acute Aortic Dissection, an Interesting Case Report

Abstract

Primary hyperaldosteronism is overproduction of aldosterone from the adrenal cortex with wide electrolyte imbalance and cardiovascular complications like aortic dissection. While the association between primary hyperaldosteronism and aortic dissection has been a subject of interest, the exact relationship and potential causative mechanisms remain unclear. We present here a 51-year-old male with no significant past medical history who came to the emergency department with severe chest pain, sudden-onset radiating to the back, shortness of breath (SOB), and diaphoresis. A chest-to-abdominal Computed Tomography (CT) angiography showed a small tear in the inner lining of the aortic arch, just below the left subclavian artery. The descending aorta had a large mural thrombosis up to the T7 level. The pressure was controlled with intravenous drugs, and then oral antihypertensive drugs and electrolytes were corrected. The patient was recommended to go outside where cardiovascular surgery is available and is now doing well in cardiology outpatient follow-up with well-controlled blood pressure.