[Aortic dissection: A challenge for the emergency medicine? A case report].

Rev Med Inst Mex Seguro Soc

1Instituto Mexicano del Seguro Social, Hospital General Regional No.1 "Carlos McGregor Sánchez Navarro", Servicio de Urgencias. Ciudad de México, México.

Published: July 2024

AI Article Synopsis

  • Acute aortic syndrome, first described in 2001, includes four conditions characterized by severe aortic pain, with aortic dissection being the most common and serious manifestation.
  • A case involves a 50-year-old man with a history of high blood pressure and chronic kidney disease who presented with abdominal pain, highlighting the importance of recognizing symptoms.
  • Accurate and timely diagnosis of acute aortic syndrome in the emergency department is crucial because the risk of mortality increases significantly with each hour that passes without treatment.

Article Abstract

Background: Acute aortic syndrome was fully described in 2001, it refers to a heterogeneous group of patients with a set of signs and symptoms where the main one is aortic pain. This syndrome encompasses a group of four acute aortic conditions: aortic dissection (AD), intramural hematoma, penetrating aortic ulcer, and incomplete dissection. Aortic dissection usually follows the sudden onset of acute chest pain, which is worse at the point of manifestation.

Case Report: 50-year-old male patient admitted to the emergency department for abdominal pain; he reported a history of systemic arterial hypertension for 22 years of diagnosis, treatment with Irbesartan (225 mg/day), chronic kidney disease without replacement therapy, with previous appendectomy 30 years ago.

Conclusion: The diagnostic difficulty of acute aortic syndrome in the emergency department has been a challenge due to the diffuse clinical picture in which it presents, but it is extremely important to have a high level of suspicion, to keep in mind that AD is an underdiagnosed etiology and to relate it to risk factors. The importance of establishing a timely diagnosis is a priority, since mortality increases from 1 to 2% per hour of elapsed time.

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http://dx.doi.org/10.5281/zenodo.11397340DOI Listing

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