A Rare Case of Asymptomatic Aortic Dissection.

BACKGROUND

Aortic dissection involves a tear leading to a false lumen. According to the Stanford classification, there are 2 main types-type A, involving the ascending aorta, and type B, exclusively involving the descending aorta. It is typically characterized by chest pain. However, some patients are asymptomatic and incidentally found with dissection.

CASE SUMMARY: A 43-year-old patient presented to a primary care physician with palpitations. Transthoracic echocardiogram revealed thoracic aortic aneurysm with a possible type A aortic dissection. A computed tomography angiography of the aorta confirmed ascending type A aortic dissection to the isthmus. The patient refused emergent evaluation and left the hospital against medical advice twice. He remained asymptomatic until surgery.

DISCUSSION: Type A aortic dissections are life-threatening illnesses. Most patients present with tearing chest pain. Atypical presentations pose a diagnostic and therapeutic challenge.

TAKE-HOME MESSAGES: Type A aortic dissection is a life-threatening illness with high mortality without an emergent surgery. Asymptomatic presentations increase morbidity and mortality.