Key result
Sexual intercourse triggered a retrograde acute type B aortic dissection presenting as severe lower-back pain in a 32-year-old man, who was treated promptly with no sequelae.
Case Report (n=1)
No
Acute aortic dissection should be considered in the differential diagnosis for patients presenting with acute-onset severe lower-back pain following strenuous exercise, regardless of age.
Supports including aortic dissection in differentials for acute back pain after intercourse even in young adults; leaves open validation in larger cohorts.
Acute aortic dissection, an emergent vascular catastrophe, varies in its clinical presentation and embraces a high mortality rate if not recognized early. Here we report a 32-year-old man who presented to our emergency department (ED) because of lower-back pain shortly before orgasm, and was subsequently found to have retrograde acute type B aortic dissection. This young man was diagnosed and treated promptly in the ED and had no sequelae. We highlight that ED physicians should always include vascular emergencies (i.e. acute aortic dissection) in their differential diagnoses whilst engaging a patient with an acute-onset severe lower-back pain featuring a characteristic upward propagation that emerges following strenuous exercise (i.e. sexual intercourse) in our case. This would appear to be especially so for patients featuring elevated blood pressure regardless of patient's age or history of hypertension.
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Hsu et al. (2008) conducted a case report in Retrograde acute type B aortic dissection (n=1). Sexual intercourse was evaluated. Sexual intercourse triggered a retrograde acute type B aortic dissection presenting as severe lower-back pain in a 32-year-old man, who was treated promptly with no sequelae.
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