Open AccessAortic dissection and stroke associated with COVID-19: case report
Author(s) -
Amanda Xavier Darella,
Stefany Elias,
Gladys Lentz Martins
Publication year - 2021
Language(s) - English
Resource type - Conference proceedings
DOI - 10.5327/1516-3180.242
Subject(s) - medicine , aortic dissection , stroke (engine) , dissection (medical) , paresis , cardiology , chest pain , anisocoria , neurological examination , surgery , ards , aorta , lung , mechanical engineering , pupil , neuroscience , engineering , biology
Case Report A 58-year-old man, previously healthy, presented with headache, myalgia, retrosternal chest pain associated with paresthesia and paresis in upper limbs and lower limbs of acute onset. He denies fever, cough, dyspnea, or contact with patients with COVID-19. There was a difference in blood pressure and pulse in the upper limbs. No particularities in the neurological examination were noted. The electrocardiogram and enzymes of myocardial necrosis did not show abnormalities. PCR for SARS-CoV-2 was positive. Chest computed angiotomography showed acute type IA aortic dissection. The patient underwent cardiac surgery, without complications. After 48 hours of the procedure, the patient progresses with a lower level of consciousness, left hemiplegia, and anisocoria. The brain computed tomography showed extensive ischemic injury in the right middle cerebral artery territory. The patient underwent decompression craniectomy. The patient was discharged from the hospital, maintaining hemiplegia on the left side of the body. Discussion SARS-CoV-2 is a RNA virus responsible for the current COVID-191 pandemic. Moderate to severe forms of the disease may present with acute respiratory distress syndrome (ARDS), myocarditis, and thrombotic events such as pulmonary venous thromboembolism and ischemic stroke2. There are few reports in the literature about acute aortic dissection in patients with COVID-193,4. Acute aortic dissection is characterized by rupture of the intimal layer of the vessel with exposure of the middle layer and cystic necrosis and formation of a false lumen5. The mechanisms associated with thromboembolic phenomena in SARSCoV-2 infection remain poorly elucidated in the literature. This case report highlights a patient with severe complications of COVID-19, with the viral trigger being a possible contributor to the condition of acute aortic dissection and stroke.