Type-A Aortic Dissection Evading Aortic Dissection Detection Score in Vulnerable Patient: A Case Report.

Area of Science:

• Emergency Medicine
• Cardiovascular Surgery
• Medical Diagnostics

Background:

• Emergency department (ED) workflows often rely on algorithms and tools.
• These systems can overlook patients with unusual symptoms, potentially missing critical diagnoses.
• Vulnerable patient populations may present with atypical signs of life-threatening conditions.

Purpose of the Study:

• To report a case of acute aortic dissection presenting atypically in an elderly female patient.
• To highlight the challenges in diagnosing rare conditions within fast-paced emergency settings.
• To emphasize the importance of considering non-classic presentations in emergency medicine.

Main Methods:

• Case report of a female patient in her late 70s.
• Initial presentation with vomiting and diarrhea after dietary indiscretion.
• Clinical course and diagnostic workup in the emergency department.
• Surgical intervention and postoperative follow-up.

Main Results:

• The patient, initially stable, developed a dynamic course necessitating further investigation.
• Diagnosis of acute aortic dissection was confirmed.
• Successful emergency aortic arch replacement was performed.
• Unremarkable postoperative recovery and one-year follow-up.

Conclusions:

• Atypical presentations of acute aortic dissection can occur, even with initial gastrointestinal symptoms.
• Vigilance and a broad differential diagnosis are crucial in emergency medicine, especially for elderly patients.
• Adherence to diagnostic protocols must be balanced with clinical judgment to avoid diagnostic errors.