A silent case of aortic dissection: a case report

Type B aortic dissection is a relatively rare clinical condition with, however, a significant clinical impact and therefore an early diagnosis is necessary. The clinical presentation is highly variable depending on the aortic district involved and the presence of signs secondary to hypoperfusion. This peculiarity makes diagnosis even more difficult. We describe the case of a 52-year-old patient who presented to our emergency department with significant chest pain and crisis; his medical history was silent and there were no known cardiovascular risk factors. The ultrasonographic, electrocardiographic, laboratory and semeiological findings and the resulting diagnostic pathways were totally negative. Only advanced diagnostics allowed the diagnosis of aortic dissection. This case allows us to reflect on the interpretation of blood chemistry tests and the application of diagnostic scores/pathways in everyday clinical practice, especially in less defined clinical pictures.