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Updated: Jun 6, 2026
06:26
Novel and Innovative Hybrid Technique for Type A Aortic Dissection
Published on: March 28, 2025
Painless acute aortic dissection. - Diagnostic, prognostic and clinical implications.-.
Hiroshi Imamura1, Yukio Sekiguchi, Tomomi Iwashita
1Department of Emergency and Intensive Care Medicine, Shinshu University School of Medicine, Matsumoto, Japan. imamura@shinshu-u.ac.jp
Summary
Painless acute aortic dissection (AAD) may be more common than thought. Patients without pain often show altered consciousness or neurological deficits, leading to worse outcomes despite similar mortality rates.
Area of Science:
- Cardiology
- Vascular Surgery
- Emergency Medicine
Background:
- Acute aortic dissection (AAD) typically presents with severe chest, back, or abdominal pain.
- Atypical presentations of AAD, including painless cases, are less understood.
- Investigating painless AAD is crucial for improving diagnosis and patient outcomes.
Purpose of the Study:
- To investigate the clinical characteristics and outcomes of patients with painless AAD.
- To compare painless AAD with the classic painful presentation.
- To identify key differences in presentation, complications, and prognosis.
Main Methods:
- Retrospective analysis of 98 AAD patients admitted between 2002 and 2007.
- Categorization into painless (16 patients) and painful (82 patients) groups.
- Comparison of demographic data, presenting symptoms, dissection type, complications, and outcomes.
Main Results:
- Painless AAD (17%) more frequently presented with disturbed consciousness, syncope, or focal neurologic deficits.
- Cerebral ischemia and cardiac tamponade were more common complications in the painless group.
- In-hospital mortality was similar, but painless AAD patients had poorer functional outcomes.
Conclusions:
- Painless AAD is a significant clinical entity that may be underdiagnosed.
- Altered consciousness and neurological deficits are key indicators of painless AAD.
- Painless AAD is associated with higher morbidity and unfavorable functional outcomes.
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