Key result
Endovascular repair was successfully performed in a 60-year-old man with a missed Stanford type B aortic dissection, resulting in a good postoperative recovery.
Case Report (n=1)
This case highlights the importance of maintaining a high index of suspicion for acute aortic dissection in patients presenting with chest pain radiating to the back, as symptoms can mimic other conditions and lead to misdiagnosis.
Urges vigilance for aortic dissection in atypical chest pain despite negative ACS workup; leaves open optimal ED diagnostic pathways.
A 60-year-old man with a history of indigestion and untreated hypertension presented with sudden-onset central chest pain which radiated to his back. Acute coronary syndrome was initially suspected but excluded in the emergency department before the patient was discharged. The pain subsequently abated to mild intermittent episodes and was misdiagnosed as indigestion. A week later the patient developed new shortness of breath and 'flu-like' symptoms with a positive d-dimer test. CT angiography revealed a Stanford type B aortic dissection which was causing hypoperfusion of the right kidney, resulting in an acute kidney injury. Due to uncontrolled hypertension despite rigorous antihypertensive medication and his failing renal function, the patient underwent endovascular repair and made a good recovery postoperatively.
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Wong et al. (2018) conducted a case report in Acute aortic dissection (n=1). Endovascular repair was evaluated on Postoperative recovery. Endovascular repair was successfully performed in a 60-year-old man with a missed Stanford type B aortic dissection, resulting in a good postoperative recovery.
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