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  • Title: Silent stealth: painless aortic dissection masquerading as heart failure.
    Author: Riaz S, Ahmed D, Omoregbee BI, Butt H, Naqvi SY.
    Journal: BMJ Case Rep; 2024 Sep 20; 17(9):. PubMed ID: 39306334.
    Abstract:
    A male patient in his 50s presented to the emergency department with a three-day history of shortness of breath, New York Heart Association class IV, and oxygen desaturation. His physical examination revealed a large volume radial pulse with bibasal crepitation in the lungs and a soft diastolic murmur in the aortic area on auscultation of his heart. He was managed on the line of decompensated heart failure. Transthoracic echocardiography showed a dissection flap in the ascending aorta with acute severe aortic regurgitation. A subsequent urgent CT angiography of the whole aorta confirmed a complex type A aortic dissection with an aneurysmal ascending aorta. An emergency type A aortic dissection repair (modified Bentall's procedure) was done. The patient made a good recovery, was discharged successfully 2 weeks after the procedure and was doing well on postoperative follow-up.
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