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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 distributed under the terms of the CC BY-NC-ND 4.0 license which allows users to copy and distribute the manuscript, as long as this is not done for commercial purposes and further does not permit distribution of the manuscript if it is changed or edited in any way, and as long as the user gives appropriate credits to the original author(s) and the source (with a link to the formal publication through the relevant DOI) and provides a link to the 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

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