Abstract
Background
Patients with medical conditions may present with psychiatric symptoms, which may
lead to worse physical health care. Here we present the case of a patient with acute
aortic dissection masked by psychiatric symptoms after a stressful event.
Case Report
A 29-year-old female medical student presented to the Emergency Department (ED) complaining
about the feeling of “hysteria” after an argument with her boyfriend earlier the same
day. She did not report other symptoms or pain. Careful physical examination, initially
impeded by the patient's agitation, revealed pulseless extremities. Blood gas analysis
showed metabolic acidosis. Transthoracic echocardiography and computed tomography
ultimately led to the correct diagnosis: Stanford Type-A aortic dissection.
Why Should an Emergency Physician Be Aware of This?
Medical conditions requiring acute diagnostic work-up and therapy may present with
psychiatric symptoms. Increased awareness and the use of standardized operating procedures
in the ED may prevent fatal misdiagnoses in these patients.
Keywords
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References
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Article info
Publication history
Published online: August 10, 2015
Accepted:
May 29,
2015
Received in revised form:
May 14,
2015
Received:
January 8,
2015
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
