Mandibular pain can be a rare initial symptom of acute aortic dissection without coronary obstruction, highlighting the need for careful evaluation of atypical symptoms in elderly patients.
Atypical mandibular pain may prompt aortic dissection evaluation in the elderly; this case leaves open broader diagnostic implications.
An 88-year-old woman experienced sharp pain in the left mandible for a few minutes 3 days prior to hospital presentation. On the day of hospital presentation, the patient experienced similar pain and cold sweating for more than an hour early in the morning. On arrival, there was only mild discomfort ranging from the left mandible to the neck, without definite pain. Computed tomography revealed Stanford type A acute aortic dissection. Blood vessel prosthesis implantation was performed. Intraoperatively, the coronary arteries were confirmed to be intact. Mandibular pain is a rare but potential symptom of aortic dissection without coronary artery obstruction.
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Tago et al. (2017) studied this question.
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