Aortic Dissection Associated With Seizures

We present a case of an extensive aortic dissection identified in a young male patient with atypical symptoms. The patient presented to the Emergency Department with severe sudden onset chest pain and seizure. In the Emergency Department, bedside Transthoracic Echocardiography (TTE) identified moderate pericardial effusion which correlated with a widened mediastinum on chest radiograph. The presence of aortic dissection was confirmed by an urgent CT angiogram of the thorax and abdomen. Our case highlights the importance of critical thinking in the atypical presentation of aortic dissection in which this diagnosis may not be considered, leading to negative and possibly deadly outcomes.