Aortic Dissection with Haemothorax Mimicking a Stroke

Joana Ricardo Pires; Mariana Teixeira; Margarida Ferreira; Clarinda Neves

doi:10.12890/2019_001277

Aortic Dissection with Haemothorax Mimicking a Stroke

Eur J Case Rep Intern Med. 2019 Nov 4;6(11):001277. doi: 10.12890/2019_001277. eCollection 2019.

Authors

Joana Ricardo Pires¹, Mariana Teixeira¹, Margarida Ferreira², Clarinda Neves¹

Affiliations

¹ Internal Medicine Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.
² Radiology Department, Centro Hospitalar do Baixo Vouga, Aveiro, Portugal.

Abstract

Aortic dissection is a life-threatening clinical emergency and a challenging diagnosis. Depending on its initial location, it may present with several symptoms with the most common being chest pain. We describe the case of a 62-year-old man admitted to the Emergency Department with acute neurological deficits and triaged for the stroke protocol. After unexpected findings on physical examination, other diagnostic hypotheses were evaluated, culminating in the diagnosis of aortic dissection with haemothorax mimicking a stroke.

Learning points: Aortic dissection is a clinical emergency with a high rate of misdiagnosis; it may present with unusual symptoms depending on its initial location.Stroke mimics are diverse non-vascular conditions that can present with acute neurological deficits simulating an acute stroke, some of which are contraindications for thrombolytic treatment.An accurate initial physical examination in the emergency department is crucial so less common conditions can be evaluated and fatal thrombolytic treatment avoided.

Keywords: Aortic dissection; emergency medicine; haemothorax; stroke.

Publication types

Case Reports