A 60-year-old female with a past medical history of hypertension presents to the ED with one day of throbbing left knee pain with associated numbness that worsened with ambulation. EKG shows lateral T-wave inversions with no prior for comparison. The patient had bloodwork drawn and a chest x-ray ordered. Her pain was improving with acetaminophen, and during further workup, she went into cardiac arrest. The advanced cardiac life support protocol was initiated, the patient was intubated, and point-of-care ultrasound revealed pericardial effusion. Despite all her efforts, she couldn't regain consciousness and was pronounced dead. An autopsy confirmed that the patient suffered a type A aortic dissection (AD), with findings indicating a predisposing genetic component. This case confirms that type A AD can present with different clinical symptoms and that a high index of suspicion is crucial in providing lifesaving measures.
Keywords: aortic injury; aortic surgery; atypical chest pain; atypical presentation of aortic dissection; type a aortic dissection.
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