Key result
A 34-year-old male with a Stanford B descending aortic dissection presented atypically with profound sinus bradycardia (38 bpm) despite severe pain, which resolved following successful thoracic endovascular aortic repair.
Case Report (n=1)
No
This case demonstrates that profound sinus bradycardia can paradoxically occur in the acute setting of a painful Stanford B descending aortic dissection, a phenomenon typically associated only with Stanford A dissections.
Bradycardia may occur in Stanford B dissection; leaves open whether this association is underrecognized or coincidental.
A 34-year-old uncontrolled hypertensive male presented with chest pain radiating to the back. Despite severe pain, he was persistently bradycardic at 38 beats per minute. The workup at the emergency department confirmed the presence of an acute Stanford B aortic dissection. Stanford B dissections are not usually associated with bradycardia. It is Stanford A dissections that are mostly linked with bradycardia because Stanford A dissections can cause concomitant coronary artery extension and involvement of the atrioventricular node. This case demonstrates that sinus bradycardia can exist in the acute setting of any painful aortic dissection, even though it might not necessarily involve the coronary arteries.
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Fenech et al. (2023) conducted a case report in Descending Aortic Dissection (n=1). Thoracic endovascular aortic repair (TEVAR) was evaluated on Resolution of symptoms and bradycardia. A 34-year-old male with a Stanford B descending aortic dissection presented atypically with profound sinus bradycardia (38 bpm) despite severe pain, which resolved following successful thoracic endovascular aortic repair.
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