Isolated Neck Pain as an Atypical Manifestation of Type A Acute Aortic Dissection: A Case Report.

BACKGROUND Acute aortic dissection (AAD) is a life-threatening cardiovascular emergency that is most commonly associated with severe chest or back pain. Atypical symptoms such as isolated neck pain may lead to delayed diagnosis and treatment, increasing the risk of mortality. In this report, we present a diagnostically challenging case of AAD with atypical symptoms in order to increase clinical awareness and support earlier recognition of such presentations. CASE REPORT A 30-year-old man with obesity, a 10-pack-year smoking history, arterial hypertension, and a family history of AAD presented with isolated neck pain and a transient presyncopal episode following mild exertion. Laboratory tests showed leukocytosis and elevated D-dimer, troponin, and NT-proBNP levels. Transthoracic echocardiography raised suspicion of Type A AAD, although the initial contrast-enhanced computed tomography (CT) scan did not confirm the diagnosis. Due to continued clinical concerns, CT scan was repeated, and it revealed a Stanford Type A dissection. The patient underwent emergency surgery involving the resection of the affected segment of the ascending aorta and graft replacement using a synthetic prosthesis. His postoperative course was uneventful, and he remained asymptomatic at follow-up. CONCLUSIONS This case report highlights isolated neck pain as an atypical but potentially critical presentation of Type A AAD. Early recognition of atypical features in high-risk patients is essential. Multimodal imaging is crucial for timely diagnosis and improved survival outcomes.