PAINLESS AORTIC DISSECTION IN A HEALTHY 42-YEAR-OLD MAN WITHOUT RISK FACTORS

Sawssane Khalloud*, Hajar El Ouartassi, Iliyass Asfalou, Younes Moutakillah and Aatif Benyass

ABSTRACT

Aortic dissection is an acute aortic syndrome described as "lightning bolt in a clear sky". It’s a vascular emergency that if not diagnosed and treated in a timely manner can result in death. Classically, aortic dissection presents as sudden, severe chest, back, or abdominal pain that is characterized as ripping or tearing in nature. However, several cases with atypical symptoms have been reported. We present a 42 year old male with no significant past medical history presented to the Emergency Department with a progressive shortness of breath and weakness over three days with no chest pain. The patient was clinically stable with normal electrocardiogram and negative troponin. Consequently, he was discharged from the Emergency Department. Ten days later, he consulted a cardiologist for persistent dyspnea. A transthoracic echocardiogram was performed and revealed an aneurysm of the thoracic aorta measuring 61 mm in diameter, type A aortic dissection extending from the sinus of Valsalva to the subrenal aorta, severe aortic regurgitation and pericardial effusion. The patient underwent immediate Bentall surgery, and ultimately had a successful outcome.

Keywords: Acute aortic dissection, Atypical symptoms, Chest pain, Dyspnea.