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Spontaneous Extensive Type A Aortic Dissection in an Older Female with No Risk Factors: A Rare Clinical Presentation
Maulik K Lathiya1, Susan M Cullinan1
1Emergency Department, Mayo Clinic Health System, Eau Claire, WI, USA.
Case Reports in Emergency Medicine
|January 3, 2024
Summary
Aortic dissection (AD) can present with unusual symptoms and mimic heart attacks, even without typical risk factors. Early recognition of AD, even with atypical ECG changes, is crucial for timely diagnosis and treatment.
Area of Science:
- Cardiology
- Vascular Surgery
- Diagnostic Imaging
Background:
- Aortic dissection (AD) is a life-threatening condition involving a tear in the aorta's inner lining.
- AD is less common in females and can present with atypical symptoms, complicating diagnosis.
- Distinguishing AD from acute coronary syndrome (ACS) is challenging due to overlapping symptoms and ECG findings.
Observation:
- A 60-year-old female presented with atypical chest, neck, arm, and lower extremity pain.
- Electrocardiogram (ECG) showed ST elevation and depression, mimicking ACS.
- Initial treatment for suspected ACS did not alleviate symptoms.
Findings:
- CT angiography confirmed type A aortic dissection extending from the aortic root to the iliac artery.
- The patient's condition improved significantly after immediate surgical intervention.
Implications:
- Highlights the importance of considering AD in patients with unusual symptoms and ECG changes, even without traditional risk factors.
- Emphasizes the need for high clinical suspicion for AD in emergency settings.
- Underscores the critical role of prompt diagnosis and surgical management in improving outcomes for aortic dissection.
