CASE REPORT  NON-COVID-19 SECTION Open access

Italian Journal of Emergency Medicine 2021 August;10(2):101-3

DOI: 10.23736/S2532-1285.21.00059-8

Copyright © 2021 THE AUTHORS

This is an open access article under the CC BY-NC-ND license

lingua: Inglese

When there is no pain: a case of silent acute aortic dissection

Mariairene BENEDUSI ¹ ✉, Enrico R. BREGANI ², Matilde CONTI ¹

¹ Emergency Medicine, University of Milano-Bicocca, Milan, Italy; ² Unit of General Medicine, Hemostasis and Thrombosis, Maggiore Polyclinic Hospital, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milan, Italy

We described the case of a 67-year-old man presenting to the ED with syncope and initial normal vital signs and resulting in a challenging diagnosis of a painless aortic dissection (AD). The discussion was focused on the significant incidence of atypical presentation of AD, the related high risk of a misdiagnosis and the role of instrumental tools such as bedside ultrasound and CT scan. In conclusion, we considered that the combined use of clinical suspect, based on clinical signs and laboratory tests, and of imaging techniques could help to reach a certain diagnosis even in the painless AD presentation.

KEY WORDS: Syncope; Dizziness; Arrythmias, cardiac; Cardiac tamponade; Shock, cardiogenic