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Resident PGY 2
Henry Ford Wyandotte
Aortic dissection is a rare and life-threatening condition that frequently mimics more common causes of chest pain. This often leads to a missed or delayed diagnosis which can have disastrous consequences for the patient. It is imperative that physicians recognize the variable presentations of this life-threatening illness as early diagnosis and treatment are crucial to the outcome of the patient. We present the case of a 77-year-old female with a past medical history of hypertension, aortic stenosis, TAVR, and ESRD, who presented to the ED with chest pain and massive hemoptysis. PE was suspected,and CT PE was performed revealing an aortic dissection involving the ascending aorta and mediastinal hemorrhage with blood compressing the right main pulmonary artery.This case not only demonstrates the variable presentation of this critical diagnosis, but also raises the question of whether undergoing TAVR increases the risk of developing an aortic dissection, and also illustrates the possible utility of CT PE in the diagnosis of this condition.
Fletcher, William; Nedzlek, Christopher; and Gunaga, Satheesh, "Acute Aortic Dissection Presenting with Massive Hemoptysis and History of TAVR" (2019). Case Reports. 129.