Aortic dissection presenting with respiratory failure: case report and literature

Abstract

Due to its nonspecific symptoms, in several cases, Acute Aortic Dissection (AAD) is a difficult-to-diagnose urgent condition. The torn intimal layer initiates a false lumen, which can potentially propagate and cause life-threatening ruptures or organ ischemia. Intramural hematoma can rarely develop inside the false lumen, resulting in compression of surrounding structures and worsening the patient’s prognosis. We report a case of AAD - Stanford Type A complicated by an intramural hematoma compressing the pulmonary artery, accompanied by a discussion of relevant literature. This patient presented to the emergency department with acute respiratory distress; clinical and initial diagnostic findings mimicked pulmonary embolism. However, a systematic differential evaluation supported by point-of-care ultrasound allowed a prompt diagnosis of AAD and avoided fixation errors.