Department of Emergency Medicine, Lebanese American University Medical Center, Beirut, Lebanon.
Lebanese American University, School of Medicine, Beirut, Lebanon.
Pan Afr Med J. 2023 Feb 16;44:91. doi: 10.11604/pamj.2023.44.91.38533. eCollection 2023.
Aortic dissection is an uncommon yet frequently fatal illness. Patients generally present with tearing chest pain with possible acute hemodynamic instability. Hence, early diagnosis and intervention is critical for survival. This is a case of a 62-year-old male who was transferred to our emergency department for severe chest pain, left side hemiplegia, left hemianopsia, left facial weakness, suggesting a right-sided stroke. A chest computed tomography angiogram showed an extensive circumferential aortic dissection of the intimal layer involving the great vessels. Antiplatelet medications were withheld, nicardipine was started, and the cardiothoracic surgeon was consulted. There was no indication for surgery, and patient was admitted to the intensive care unit. We highlight here the importance of considering an aortic dissection in patients who present with neurological symptoms and an acute history of tearing chest pain.
主动脉夹层是一种不常见但常致命的疾病。患者通常表现为撕裂样胸痛，可能伴有急性血流动力学不稳定。因此，早期诊断和干预对生存至关重要。这是一位 62 岁男性的病例，他因严重胸痛、左侧偏瘫、左侧偏盲、左侧面部无力被转至我们的急诊部，提示右侧卒中。胸部 CT 血管造影显示广泛的内膜层主动脉夹层累及大血管。停用抗血小板药物，开始使用尼卡地平，并咨询心胸外科医生。没有手术指征，患者被收入重症监护病房。我们在此强调，对于出现神经症状和急性撕裂样胸痛的患者，考虑主动脉夹层的重要性。
