Abstract
Background
Throat pain is a common complaint in the emergency department. The related diagnoses
are varied, from simple gastroesophageal reflux disease to catastrophic aortic dissection.
This case highlights the importance of pertinent patient history and frequent reassessments
in order to recognize the latter.
Case Report
A 58-year-old woman was found to have a type A aortic dissection after initially presenting
to the emergency department with a chief complaint of “burning” throat pain. Throughout
the patient's evaluation in the emergency department, her symptoms evolved from the
complaint of mild throat pain and water brash to development of chest pain and sudden
right lower extremity cramping. Her history of hypertension, smoking, and a previous
cerebral aneurysm prompted further intervention, including aggressive blood pressure
control and emergent imaging. A computed tomography scan with angiography revealed
the diagnosis of a type A aortic dissection.
Why Should an Emergency Physician be Aware of This?
We highlight the importance of recognizing that patient presentation may change throughout
the course of the emergency department stay, and that our case represents an atypical
presentation of serious disease.
Keywords
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References
- Diagnosis of aortic dissection in emergency department patients is rare.West J Emerg Med. 2015; 16: 629-631
- Acute aortic dissection in the ED: risk factors and predictors for missed diagnosis.Am J Emerg Med. 2012; 30: 1622-1626
- Aortic dissection and related aortic syndromes.in: Tintinalli J.E. Stapczynski J. Ma O. Tintinalli’s emergency medicine: a comprehensive study guide. 8th ed. McGraw-Hill, New York, NY2016
- Acute aortic syndromes and thoracic aortic aneurysm.Mayo Clin Proc. 2009; 84: 465-481
- Acute thoracic aortic dissection presenting as sore throat: report of a case.Yale J Biol Med. 2004; 77: 53-58
- Clinical features and differential diagnosis of aortic dissection: experience with 236 cases (1980 through 1990).Mayo Clin Proc. 1993; 68: 642-651
Article info
Publication history
Published online: August 01, 2019
Accepted:
May 6,
2019
Received in revised form:
April 17,
2019
Received:
July 13,
2018
Footnotes
Reprints are not available from the authors.
Identification
Copyright
© 2019 Published by Elsevier Inc.
