Published online Jan 6, 2021. doi: 10.12998/wjcc.v9.i1.232
Peer-review started: August 26, 2020
First decision: November 3, 2020
Revised: November 5, 2020
Accepted: November 13, 2020
Article in press: November 13, 2020
Published online: January 6, 2021
Processing time: 127 Days and 22 Hours
Aortic dissection (AD) is a life-threatening condition with a high mortality rate without immediate medical attention. Early diagnosis and appropriate treatment are critical in treating patients with AD. In the emergency department, patients with AD commonly present with classic symptoms of unanticipated severe chest or back pain. However, it is worth noting that atypical symptoms of AD are easily misdiagnosed.
A 51-year-old woman was first diagnosed with scapulohumeral periarthritis due to left shoulder pain. After careful examination of her previous medical history and contrast-enhanced computed tomography angiography, the patient was diagnosed with a new type A AD after chronic type B dissection in the ascending aorta. The patient was successfully treated with surgical replacement of the dissected aortic arch and remains in good health.
New retrograde type A AD after chronic type B dissection is relatively rare. It is worth noting that a physician who has a patient with suspected AD should be vigilant. Both patient medical history and imaging tests are crucial for a more precise diagnosis.
Core Tip: We report a case of new retrograde type A aortic dissection, which developed after type B aortic dissection. This case is special for only presenting mild left shoulder pain. Hence, detailed medical history and imaging tests are crucial for patients with atypical symptoms.