Aortic dissection (AD) is a rare but serious vascular emergency that requires rapid diagnosis and intervention. We report the case of a 58-year-old male with a history of poorly controlled hypertension and prior abdominal aortic aneurysm who presented with an extensive Stanford Type A AD originating near the aortic arch and propagating throughout the thoracic and abdominal aorta into the bilateral iliac arteries, extending distally to the left common femoral artery. Proximally, the dissection involved the innominate, subclavian, and bilateral carotid arteries, resulting in severely compromised cerebral perfusion. This case highlights an exceptionally extensive form of AD with near pan-aortic involvement and widespread branch vessel propagation affecting cerebral, visceral, and peripheral circulations. It also underscores the atypical presentation of AD as sudden cardiac arrest without preceding symptoms, emphasizing the need for a high index of suspicion and comprehensive vascular imaging to accurately assess disease extent and guide management.
Zaman et al. (Wed,) studied this question.