Type A aortic dissection developed after type B dissection with the presentation of shoulder pain: A case report

• Published in: World journal of clinical cases Vol. 9; no. 1; pp. 232 - 235
• Main Authors: Yin, Xin-Bo, Wang, Xiao-Kai, Xu, Su, He, Cai-Yun
• Format: Journal Article
• Language: English
• Published: United States Baishideng Publishing Group Inc 06.01.2021
• Subjects: Case Report; Case report; Chronic type B aortic dissection; Atypical symptoms; Misdiagnosis; Shoulder pain; Emergency setting; New type A aortic dissection
• ISSN: 2307-8960; 2307-8960
• DOI: 10.12998/wjcc.v9.i1.232

Aortic dissection (AD) is a life-threatening condition with a high mortality rate without immediate medical attention. Early diagnosis and appropriate treatment are critical in treating patients with AD. In the emergency department, patients with AD commonly present with classic symptoms of unanticipated severe chest or back pain. However, it is worth noting that atypical symptoms of AD are easily misdiagnosed. A 51-year-old woman was first diagnosed with scapulohumeral periarthritis due to left shoulder pain. After careful examination of her previous medical history and contrast-enhanced computed tomography angiography, the patient was diagnosed with a new type A AD after chronic type B dissection in the ascending aorta. The patient was successfully treated with surgical replacement of the dissected aortic arch and remains in good health. New retrograde type A AD after chronic type B dissection is relatively rare. It is worth noting that a physician who has a patient with suspected AD should be vigilant. Both patient medical history and imaging tests are crucial for a more precise diagnosis.