An Atypical presentation of Acute Aortic Dissection in the Emergency Department

Background: Acute aortic dissection, an emergent vascular catastrophe, varies in its clinical presentation and embraces a high mortality rate if not recognized early. The symptoms of acute aortic dissection may vary. Most patients complain of an abrupt onset of severe pain in the chest, back, or abdomen. Other uncommon presentation may be shortness of breath, pain in the arms or legs, weakness, or loss of consciousness. Case Report: We present a 50 year old male who presented with complaints of sudden onset of shortness of breath, sweating and pain in the right leg 30 minutes before arrival. Patient was diagnosed as having acute aortic dissection (Stanford Type A) with cardiac tamponade. Patient underwent a successful Bentall's procedure. Conclusion: Acute aortic dissection is uncommon but still poses a clinical challenge as patients can deteriorate very quickly. Patients may present with varied symptoms and it is imperative for an emergency physician to have high index of suspicion to diagnose these patients as soon as possible so that appropriate care can be administered.