Journal of Yeungnam Medical Science

Yeungnam University College of Medicine, Yeungnam University Institute Medical Science (영남대 의대 학술지 편집위원회)
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Atypical presentation of DeBakey type I aortic dissection mimicking pulmonary embolism in a pregnant patient: a case report

  • Sou Hyun Lee (Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Ji Hee Hong (Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine) ;
  • Chaeeun Kim (Department of Anesthesiology and Pain Medicine, Keimyung University Dongsan Medical Center, Keimyung University School of Medicine)
  • Received : 2023.12.04
  • Accepted : 2023.12.28
  • Published : 2024.04.30
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Abstract

Aortic dissection in pregnant patients results in an inpatient mortality rate of 8.6%. Owing to the pronounced mortality rate and speed at which aortic dissections progress, efficient early detection methods are crucial. Here, we highlight the importance of early chest computed tomography (CT) for differentiating aortic dissection from pulmonary embolism in pregnant patients with dyspnea. We present the unique case of a 38-year-old pregnant woman with elevated D-dimer and N-terminal pro-brain natriuretic peptide (NT-proBNP) levels, initially suspected of having a pulmonary embolism. Initial transthoracic echocardiography did not indicate aortic dissection. Surprisingly, after an emergency cesarean section, a chest CT scan revealed a DeBakey type I aortic dissection, indicating a diagnostic error. Our findings emphasize the need for early chest CT in pregnant patients with dyspnea and elevated D-dimer and NT-proBNP levels. This case report highlights the critical importance of considering both aortic dissection and pulmonary embolism in the differential diagnosis of such cases, which will inform future clinical practice.

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References

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