Misdiagnosing aortic dissection: a fatal mistake

Acute aortic dissection is one of the most fatal cardiovascular disorders that can challenge the most experienced practitioner. Despite recent progress in diagnostic tools, this vascular catastrophe is often misdiagnosed or undetected which can result in a 1%-3% mortality risk per hour. Many patients die before presenting to the hospital or prior to diagnosis. Therefore, a high index of clinical suspicion is critical to reach the correct diagnosis, if proper management is to be achieved. Clinical predictors for aortic dissection include abrupt chest pain or back pain, pulse and blood pressure differentials, and a radiographic widening of the mediastinum. A clear understanding of the pathophysiology and risk factors associated with aortic dissection is the cornerstone of prompt diagnosis and treatment. This paper will provide an overview of the etiology, pathology, clinical presentation, diagnosis and treatment of this condition.