More than just muscle spasms: a rare presentation of aortic dissection

Abstract

Acute aortic dissection is associated with significant morbidity and mortality, often from complications including aortic regurgitation, cardiac tamponade and myocardial infarction. Typical clinical presentation includes a sudden onset of severe chest pain, although this is not always consistent. Clinical signs and symptoms are diverse with an estimated 38% of cases being missed on initial evaluation. Primary neurological symptoms at presentation are rare but have been reported often to coexist with chest pain. We present a case of acute aortic dissection in which the initial presenting symptoms were predominantly neurological. Stanford type A dissection is a surgical emergency with a high burden of cardiovascular death; thus, aggressive identification and management is paramount. Our case re-emphasises the importance of having a higher index of suspicion and a keen clinical eye for atypical presentations of acute aortic dissection.

The usefulness of point-of-care ultrasound in the atypical presentation of aortic dissection: a case series and brief review of literature

“…19 The importance of the rapid and certain diagnosis of aortic dissection is even more true, especially when considering the differential diagnosis with acute coronary syndromes, whose therapy is potentially harmful. 4,20 Literature data support the use of computed tomography for diagnosis in cases showing an indicative or suspicious clinic; 13 however cases with atypical presentation (Table 2 [21][22][23][24][25][26][27][28][29][30][31] ) escape the usual diagnostic algorithms, and the suspicion is formulated only after multiple imaging studies are performed, with considerable delay.…”