Key result
Painless acute aortic dissection presents a diagnostic dilemma with high mortality, requiring high clinical suspicion in patients with risk factors and unexplained multi-organ ischemic symptoms.
Highlights the importance of maintaining a high index of suspicion for painless aortic dissection in high-risk patients presenting with unexplained ischemic symptoms.
Raises suspicion for painless aortic dissection in unexplained multi-organ ischemia; leaves open need for validated diagnostic protocols.
Aortic dissection is the most catastrophic clinical condition that involves the aorta. It has a high mortality as well as high rate of misdiagnosis due to frequent unusual presentation. Typically, it presents with acute chest, back, and tearing abdominal pain. However, it can present atypically with minimal or no pain, making diagnosis difficult. Physicians should always suspect acute aortic dissection in patients with certain clinical conditions like difficult-to-control hypertension, giant cell arteritis, bicuspid aortic valve, intracranial aneurysms, simple renal cysts, family history of aortic disease, and Marfan syndrome, especially when a patient presents with ischemic symptoms involving multiple organ without an obvious cause.
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Fatima et al. (2017) conducted a review in Aortic dissection. Painless presentation was evaluated. Painless acute aortic dissection presents a diagnostic dilemma with high mortality, requiring high clinical suspicion in patients with risk factors and unexplained multi-organ ischemic symptoms.
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