title: Type A Aortic Dissection Presenting with Acute Lower Extremity Vascular Insufficiency in the Absence of Chest Pain.
abstract: We report a case of a 53 year-old man with a history of hypertension presenting with acute left lower extremity parasthesias and pulselessness initially presumed to be secondary to arterial thrombosis or embolism. Work-up included a transthoracic echocardiogram which revealed an aortic dissection at the level of the aortic root extending to the visualized portions of the descending aorta. Type A aortic dissections are relatively rare, with the vast majority of patients presenting with chest pain. Timely diagnosis of Type A aortic dissections are critical as to facilitate rapid surgical repair. To our knowledge, this is the first report of a painless Type A aortic dissection presenting with isolated lower extremity vascular insufficiency and demonstrates the potential role of transthoracic echocardiography as a rapid, non-invasive bedside modality in visualizing Type A aortic dissections.
authors.affiliation: Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Division of Cardiology, Rhode Island, USA.
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Earl
authors.affiliation: Rhode Island Hospital, The Warren Alpert Medical School of Brown University, Division of Cardiology, Rhode Island, USA.
authors.forename: Athena
authors.initials: A
authors.lastname: Poppas
keywords: painless aortic dissection