[Aortic dissection: A challenge for the emergency medicine? A case report]

Acute aortic syndrome was fully described in 2001, it refers to a heterogeneous group of patients with a set of signs and symptoms where the main one is aortic pain. This syndrome encompasses a group of four acute aortic conditions: aortic dissection (AD), intramural hematoma, penetrating aortic ulcer, and incomplete dissection. Aortic dissection usually follows the sudden onset of acute chest pain, which is worse at the point of manifestation.

50-year-old male patient admitted to the emergency department for abdominal pain; he reported a history of systemic arterial hypertension for 22 years of diagnosis, treatment with Irbesartan (225 mg/day), chronic kidney disease without replacement therapy, with previous appendectomy 30 years ago.

The diagnostic difficulty of acute aortic syndrome in the emergency department has been a challenge due to the diffuse clinical picture in which it presents, but it is extremely important to have a high level of suspicion, to keep in mind that AD is an underdiagnosed etiology and to relate it to risk factors. The importance of establishing a timely diagnosis is a priority, since mortality increases from 1 to 2% per hour of elapsed time.