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Related Experiment Video

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Precision Induction and Distinction of Coughing and Sneezing Reflexes in Mice
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A sneeze: an unusual trigger for aortic dissection.

Subramanya G N Upadhyaya1, A Large

  • 1Department of Cardiology, University Hospital North Staffordshire, Stoke-On-Trent, Staffordshire, UK.

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A rare case of type B thoracic aortic dissection occurred in a 57-year-old man after a forceful sneeze. This condition, presenting with atypical chest pain and breathlessness, was incidentally diagnosed via CT pulmonary angiography.

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Area of Science:

  • Cardiology
  • Thoracic Surgery
  • Medical Imaging

Background:

  • Aortic dissection is a serious cardiovascular condition involving a tear in the aorta's inner layer.
  • Type B aortic dissection typically affects the descending aorta and can be spontaneous or associated with hypertension.
  • Forceful actions, like sneezing, can precipitate aortic events due to sudden intrathoracic pressure changes.

Observation:

  • A 57-year-old male presented with unusual symptoms of pleuritic chest pain and breathlessness.
  • The symptoms began immediately after experiencing a forceful sneeze.
  • The patient was hemodynamically stable, with no signs of shock or significant blood pressure drop.

Findings:

  • Computed tomography pulmonary angiography (CTPA) revealed a type B thoracic aortic dissection.
  • The diagnosis was incidental, discovered during a work-up for a suspected pulmonary embolism.
  • No underlying cause or predisposing factor for the dissection was immediately apparent.

Implications:

  • This case highlights that forceful sneezing can be a trigger for thoracic aortic dissection, even in the absence of typical risk factors.
  • Atypical presentations of aortic dissection necessitate a high index of suspicion, especially when symptoms follow sudden physical exertion.
  • Incidental diagnosis via imaging for other conditions underscores the importance of thorough radiological review.