European Journal of Cardiovascular Medicine

Background:  There are four major acute aortic syndromes 1) aortic rupture,2) aortic dissection,3) intramural hematoma, and 4) penetrating atherosclerotic ulcer. Among them here we are presenting case report on acute aortic dissection. Acute aortic dissection is a life-threatening condition in which a tear occurs in the inner layer of the aorta. Blood rushes through the tear and splits the inner and middle layers. Pulsatile aortic flow then dissects along the elastic lamellar plates of the aorta and creates a false lumen. Death from aortic dissection can be related to rupture of a proximal dissection into the pericardium precipitating cardiac tamponade or bleeding into the pleural space, dissection into the aortic valvular annulus leading to severe aortic regurgitation, obstruction of the coronary artery ostia leading to myocardial infarction, or end-organ failure due to abdominal aortic branch vessel obstruction. Case Report: 45-year-old female patient, nondiabetic, non-hypertensive, no significant past illness history came to emergency department with acute onset substernal pain with left sided chest pain 2-4 hours back with history of two episodes of vomiting at home. She described chest pain in numerical rating scale of 8-9, with character of pain as excruciating pain with doomed feeling, diaphoresis and difficulty in taking deep breath. She also felt slight faintness. On examination patient was conscious, restless, sweating++, she looked acutely ill but nothing specific was detected in her heart and lung sound, Initial vitals at emergency room were stable, pulse rate 120/min, blood pressure 120/84 mm Hg, respiration rate 24/min, body temperature 36.6 , saturation 99%. Electrocardiogram (ECG) was immediately taken which showed normal sinus rhythm with tachycardia, no evidence of ischemic changes. Patient shifted to ICU on ECG monitor, BP monitor, and oximeter. and started with Oxygen, Analgesics, Antiemetics.