A “sneaky” symptom of aortic dissection. Brief literature review, physiopathology and diagnostic tools management

Abstract

Aortic diseases cover a large spectrum of conditions, such as aortic aneurysm and acute aortic syndromes (i.e., dissections, intramural hematoma, penetrating atherosclerotic ulcer, traumatic aortic injuries, and pseudoaneurysms), genetic diseases (e.g., Marfan syndrome) and congenital abnormalities, such as coarctation of the aorta. These conditions may have an acute presentation; thus, if the acute aortic syndrome is the first sign of the disease, the prognosis is extremely poor. Prompt diagnosis and timely therapy are therefore mandatory. In this paper, we discuss a deceptive symptom of painless aortic dissection and its physiopathology. Furthermore, we briefly review the literature and discuss the management of diagnostic tools. Aortic dissection (AD) is a severe disease with a high mortality rate. Unfortunately, it may be diagnosed late because of the high frequency of unusual symptoms at the onset. The onset of AD is typically characterized by chest or abdominal pain, or sometimes by back pain. The literature reports several cases with atypical, painless onset, which makes the diagnosis extremely difficult.