Transient global amnesia: an atypical presentation of acute aortic dissection

Abstract

Aortic dissection (AD) is a cardiovascular emergency whose most frequent symptom is chest pain. However, clinical presentation can also be varied and atypical. In the present study we report a case of painless AD, which resulted in a sudden memory loss at presentation. Physical examination and laboratory tests regarding the patient did not show any abnormal findings and a benign transient global amnesia was diagnosed. The day after being discharged, the patient came back to the emergency department because a recurrent episode of severe memory impairment occurred. This time, additional clinical and laboratory signs suggested clinical suspicion of AD. A chest computed tomography angiogram was performed and an extensive AD type A involving carotid and iliac arteries was found. Our case report shows that acute aortic dissection diagnosis can be difficult if clinical presentation is atypical and must be assessed in the light of various clinical signs and laboratory data

A sinister needle in an enormous haystack: A clinician survey regarding Acute Aortic Syndrome diagnostic practice in United Kingdom Emergency Departments

“…Acute Aortic Syndrome (AAS) is a life-threatening condition plagued with diagnostic uncertainty. 1 It constitutes Acute Aortic Dissection (AAD), intramural haematoma and penetrating aortic ulcer. 2,3 The European Society of Cardiology definition also adds in aortic rupture and ruptured abdominal aortic aneurysms as part of the full scope of AAS.…”

“…2,5 Lack of key clinical features and investigations suggesting other diagnoses are some of the reasons that AAS is missed. 1,6 The Aortic Dissection Detection Risk Score (ADD-RS) 7 and the Canadian Clinical Practice Guideline (CCPG) 5 are two of the decision-making tools available to clinicians which can aid progression to the definitive investigation (Computed Tomography Angiography; CTA). D-Dimer has also been shown to be potentially discriminatory.…”