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[72-year-old man with syncope and left hemiparesis].
C Weiss1, C Neumeier, F Siclari
1Abteilung für Innere Medizin, Gesundheitszentrum Unterengadin, Scuol, Switzerland. christoph.weiss@cseb.ch
Der Internist
|June 10, 2011
Summary
A painless aortic dissection mimicking a stroke presented with neurological symptoms. Prompt diagnosis and surgical intervention were crucial to avoid fatal outcomes from misdirected thrombolytic therapy.
Area of Science:
- Cardiology
- Neurology
- Vascular Surgery
Background:
- Acute aortic dissection is a life-threatening condition often presenting with severe chest or back pain.
- Neurological deficits can occur but are typically associated with specific dissection types or complications.
Observation:
- A 72-year-old man presented with left hemiparesis and syncope, initially suspected as ischemic stroke.
- Clinical examination revealed pulse deficits and unmeasurable blood pressure in the left arm.
- Cranial computed tomography showed no acute abnormalities.
Findings:
- The patient was diagnosed with acute aortic dissection originating in the ascending aorta and extending to the iliac arteries.
- The dissection presented solely with neurological symptoms, complicating the initial diagnosis.
Implications:
- Painless aortic dissection with isolated neurological symptoms poses a significant diagnostic challenge.
- Misdiagnosis could lead to inappropriate thrombolytic therapy for stroke, with potentially fatal consequences.
- Early recognition and surgical management are critical for favorable outcomes in such atypical presentations.
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