Department of Emergency Medicine, Harvard Affiliated Emergency Medicine Residency, Boston, MA.
Department of Emergency Medicine, Harvard Affiliated Emergency Medicine Residency, Boston, MA.
Ann Emerg Med. 2023 May;81(5):614-617. doi: 10.1016/j.annemergmed.2022.07.010. Epub 2022 Sep 15.
Acute aortic dissection is a challenging diagnosis for emergency physicians because of its high mortality and wide range of clinical presentations. We report a case of a previously healthy man who presented with hyperfamiliarity for faces syndrome as the predominant symptom of a large type A aortic dissection diagnosed by computed tomography angiography in the emergency department. Different elements of his presentation suggested possible other diagnoses, including transient global amnesia and transient ischemic attack. We discuss how evaluating these other diagnostic possibilities led to the correct diagnosis. Given increasing reports of painless aortic dissection, this case demonstrates the need to consider aortic dissection in patients with acute neurological symptoms.
急性主动脉夹层是急诊医生面临的一项具有挑战性的诊断,因为其死亡率高且临床表现广泛。我们报告了一例先前健康的男性病例,他以高度熟悉面孔综合征为主要症状,在急诊科通过计算机断层血管造影术诊断为大型 A 型主动脉夹层。他的表现的不同元素提示可能有其他诊断,包括短暂性全面遗忘症和短暂性脑缺血发作。我们讨论了评估这些其他诊断可能性如何导致正确诊断。鉴于越来越多的无痛性主动脉夹层报告,本病例表明需要考虑急性神经症状患者的主动脉夹层。