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Published on: July 21, 2013
Silent aortic dissection presenting as transient locked-in syndrome
Wadih Nadour1, Brian Goldwasser, Robert W Biederman
1Internal Medicine Department, Allegheny General Hospital, Pittsburgh, Pennsylvania 15212, USA. NadourW@aol.com
Texas Heart Institute Journal
|October 23, 2008
Summary
Acute aortic dissection, a life-threatening condition, can present atypically. This case highlights a painless aortic dissection mimicking transient locked-in syndrome, emphasizing the need for broader differential diagnoses.
Area of Science:
- Cardiology
- Neurology
Background:
- Acute aortic dissection is a critical medical emergency with high mortality if not promptly treated.
- Atypical presentations, particularly painless ones, pose diagnostic challenges.
Observation:
- A patient presented with transient locked-in syndrome (anarthria, quadriplegia, preserved consciousness) without characteristic pain.
- Physical examination revealed a significant blood pressure difference between arms and a diastolic murmur.
Findings:
- The diagnosis of acute aortic dissection was confirmed using radiography, computed tomography, and echocardiography.
- This is the first reported case of aortic dissection presenting solely as locked-in syndrome.
Implications:
- Clinicians should consider silent aortic dissection in the differential diagnosis for transient locked-in syndrome.
- Early recognition and intervention in atypical aortic dissection cases are crucial for successful outcomes.
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