Document Type: Case Report


1 Department of Emergency Medicine, Jahrom University of Medical sciences, Jahrom, Iran

2 Department of Emergency Medicine, Kerman University of Medical sciences, Kerman, Iran

3 Research center for social Determinants of Health, Jahrom University of Medical Sciences, Jahrom, Iran


Objective: Aortic dissection is an uncommon disorder with a high mortality rate, especially if misdiagnosis and mistreatment are not considered.
Case Presentation: We present a 67-year old female with slurred speech and left sided plegia during her brother’s funeral. The patient did not have any chest pain. she was referred to our emergency department by EMS due to being suspicious of cerebrovascular accident (CVA) )as code 724). However, owing to low blood pressure and atypical symptoms of the patient, we did RUSH exam in the emergency department to detect aortic dissection. After doing the Computed tomography (CT) angiography, the diagnosis of aortic dissection was confirmed. As the vascular surgeon was not present in our surgery department, we transferred the patient to Namazi hospital by air ambulance to undergo the surgery. She was discharged from hospital with complete recovery.
Conclusion: Aortic dissection symptoms can be manifested in different ways such as pulmonary embolism, ACS, and CVA. Therefore, clinicians must always have the differential diagnosis of aortic dissection in their mind and be aware of its various manifestations.


Main Subjects

1. Rosendorff C. Essential Cardiology: Principles and Practice. Humana Pr Inc; 2005.
2. Mészáros I, Mórocz J, Szlávi J, Schmidt J, Tornóci L, Nagy L, et al. Epidemiology and clinicopathology of aortic dissection. Chest 2000; 117(5): 1271-8. doi: 10.1378/chest.117.5.1271.
3. von Kodolitsch Y, Schwartz AG, Nienaber CA. Clinical prediction of acute aortic dissection. Arch Intern Med
2000; 160(19): 2977-82. doi: 10.1001/archinte.160.19.2977.
4. Mehta RH, O’Gara PT, Bossone E, Nienaber CA, Myrmel T, Cooper JV, et al. Acute type A aortic dissection in the elderly: clinical characteristics, management, and outcomes in the current era. J Am Coll Cardiol 2002; 40(4): 685-92. doi: 10.1016/s0735-1097(02)02005-3.
5. Gawinecka J, Schönrath F, von Eckardstein A. Acute aortic dissection: pathogenesis, risk factors and diagnosis. Swiss Med Wkly 2017; 147: w14489. doi: 10.4414/smw.2017.14489.

6. Tsai TT, Evangelista A, Nienaber CA, Trimarchi S, Sechtem U, Fattori R, et al. Long-term survival in patients presenting with type A acute aortic dissection: insights from the International Registry of Acute Aortic Dissection (IRAD).Circulation 2006; 114(1 Suppl): I350-6. doi: 10.1161/circulationaha.105.000497.
7. Jänisch S, Turmanov N, Albrecht UV, Fieguth A, Günther D. [Aortic dissection - a not so rare disease]. Med Klin (Munich) 2010; 105(12): 871-5. doi: 10.1007/s00063-010-1151-2.
8. Young J, Herd AM. Painless acute aortic dissection and rupture presenting as syncope. J Emerg Med 2002; 22(2):171-4. doi: 10.1016/s0736-4679(01)00459-0.
9. Demircan A, Aksay E, Ergin M, Bildik F, Keles A, Aygencel G. Painless aortic dissection presenting with acute ischaemic stroke and multiple organ failure. Emerg Med Australas 2011; 23(2): 215-6. doi: 10.1111/j.1742-6723.2011.01389.x.
10. Imamura H, Sekiguchi Y, Iwashita T, Dohgomori H, Mochizuki K, Aizawa K, et al. Painless acute aortic dissection.- Diagnostic, prognostic and clinical implications. Circ J2011; 75(1): 59-66. doi: 10.1253/circj.cj-10-0183.