Bilateral brachial artery emboli presenting as aortic dissection

Loss of peripheral pulses in a patient with chest pain suggests the diagnosis of aortic dissection. An 80-year-old woman presented with an episode of chest pain and acute bilateral loss of upper extremity pulses that was initially treated as aortic dissection. Findings of physical examination and echocardiography were consistent with mitral stenosis. Angiography revealed bilateral brachial artery emboli, which were treated by embolectomy. To our knowledge, this case represents the first report of simultaneous brachial artery emboli in association with mitral stenosis.