Key result
A 27-year-old competitive rower presented atypically with an extensive type A aortic dissection and an 8 cm aneurysm following intense exercise, and recovered well after emergency surgery.
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Consider type A dissection in young athletes with atypical post-exercise symptoms; this Level 5 case leaves open screening implications for competitive rowing.
A 27-year-old man (who is also the lead author) presented with dull pain deep to the suprasternal notch, following a period of intense exercise (rowing). He was initially sent home with no diagnosis, but 24 hours later returned to a different Accident & Emergency (A&E), due to continued discomfort and an increasingly altered mental state, and was diagnosed with an extensive type A aortic dissection extending from the aortic root to the iliac bifurcation of the aorta, with an ~8 cm aneurysm on the ascending aorta and a diseased aortic valve. Following emergency surgery to replace the aortic valve and the aorta from the aortic root to the middle of the aortic arch (hemiarch), the patient recovered well.
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Saunders et al. (2018) studied this question. A 27-year-old competitive rower presented atypically with an extensive type A aortic dissection and an 8 cm aneurysm following intense exercise, and recovered well after emergency surgery.
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