open access

Vol 51, No 6 (2017)
Case reports
Submitted: 2017-02-09
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Atrial fibrillation and stroke as initial manifestations of painless type A aortic dissection

Claudia Stöllberger, Lilian Schäffl-Doweik, Maria Korn, Josef Finsterer
DOI: 10.1016/j.pjnns.2017.07.008
·
Neurol Neurochir Pol 2017;51(6):507-509.

open access

Vol 51, No 6 (2017)
Case reports
Submitted: 2017-02-09

Abstract

Aortic dissection is diagnostically challenging, especially in pain-free patients. Detection of acute ischemic stroke secondary to painless aortic dissection is a challenge for emergency physicians and neurologists. We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. Perfusion CT-imaging showed a dilatation of the aortic arch and intraluminal structures indicating an intima flap of aortic dissection. Four hours after onset of symptoms the patient died on the way to the cardiac surgery.

In conclusion, apart from imaging the aortic arch by computed tomography in acute stroke patients, the electrocardiogram may be indicative for aortic dissection if it shows signs for myocardial ischemia in previously healthy patients.

Abstract

Aortic dissection is diagnostically challenging, especially in pain-free patients. Detection of acute ischemic stroke secondary to painless aortic dissection is a challenge for emergency physicians and neurologists. We report a previously healthy 58-years old female, admitted because of nausea, dizziness, somnolence, a left-sided hemiparesis and arterial hypotension. The electrocardiogram showed atrial fibrillation with ST-elevations and ST-depressions. Perfusion CT-imaging showed a dilatation of the aortic arch and intraluminal structures indicating an intima flap of aortic dissection. Four hours after onset of symptoms the patient died on the way to the cardiac surgery.

In conclusion, apart from imaging the aortic arch by computed tomography in acute stroke patients, the electrocardiogram may be indicative for aortic dissection if it shows signs for myocardial ischemia in previously healthy patients.

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Keywords

Aortic dissection, Atrial fibrillation, Stroke

About this article
Title

Atrial fibrillation and stroke as initial manifestations of painless type A aortic dissection

Journal

Neurologia i Neurochirurgia Polska

Issue

Vol 51, No 6 (2017)

Pages

507-509

DOI

10.1016/j.pjnns.2017.07.008

Bibliographic record

Neurol Neurochir Pol 2017;51(6):507-509.

Keywords

Aortic dissection
Atrial fibrillation
Stroke

Authors

Claudia Stöllberger
Lilian Schäffl-Doweik
Maria Korn
Josef Finsterer

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