Open AccessIschaemic infarction masking aortic dissection: a pitfall to be avoided before thrombolysis
Author(s) -
Ju Fen Yeh,
Helen L. Po,
ChiangJu Chien
Publication year - 2009
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr.10.2008.1146
Subject(s) - medicine , aortic dissection , thrombolysis , stroke (engine) , cardiology , dissection (medical) , radiology , chest pain , carotid artery dissection , myocardial infarction , surgery , aorta , mechanical engineering , engineering
Acute aortic dissection complicated by stroke is not uncommon but may be difficult to evaluate, especially in patients with impaired mental status. This report describes a patient who had evidence of an ischaemic stroke but was fortuitously not given thrombolytic treatment. She was subsequently found to have an extensive aortic dissection involving both carotid arteries. The decision of whether to give thrombolytic treatment is understandably an urgent one, but careful attention should be paid to subtle signs and symptoms such as atypical chest pain and carotid bruits that might suggest aortic dissection, especially involving the carotid arteries. There should be a high index of suspicion for acute aortic dissection in such cases and a low threshold for performing carotid ultrasound.