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Atrial fibrillation and stroke as initial manifestations of painless type A aortic dissection
Affiliations- KA Rudolfstiftung
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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.
Keywords
Aortic dissection, Atrial fibrillation, Stroke
About this articleTitle
Atrial fibrillation and stroke as initial manifestations of painless type A aortic dissection
Journal
Neurologia i Neurochirurgia Polska
Issue
Pages
507-509
Page views
376
Article views/downloads
587
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
