27 July 2018 : Case report
An Atypical Case of Silent Aortic Dissection in a Peritoneal Dialysis Patient: A Case Report and Review of Literature
Unusual clinical course, Challenging differential diagnosis, Management of emergency care, Educational Purpose (only if useful for a systematic review or synthesis)
Waqas Javed Siddiqui12ABCDEF*, Ali Arif1EF, Mohammad Harisullah Khan3EF, Maryam Khan1E, Muhammad Owais Hanif12DE, Muhammad Junaid Mahboob4BF, Muhammad Aslam4EF, Aysha Aslam5E, Hasan Arif12BCDF, Sandeep Aggarwal16ABCDFDOI: 10.12659/AJCR.909966
Am J Case Rep 2018; 19:880-883
Abstract
BACKGROUND: Aortic dissection presents with acute chest or back pain and is associated with high mortality. We present a case of aortic dissection with an atypical presentation in a peritoneal dialysis patient, and the challenges met with peritoneal dialysis.
CASE REPORT: A 53-year-old African American male presented with progressively worsening exertional dyspnea and orthopnea for 3 days without any history of chest pain. His chest x-ray showed mild pulmonary edema. He was admitted with a diagnosis of heart failure. Bedside echocardiogram revealed severe aortic regurgitation and concern for possible aortic dissection. Computed tomography of chest with contrast showed Stanford type-A aortic dissection extending from the aortic valve to the level of the left subclavian artery. Emergent surgery was performed. Postoperatively, the patient was managed in surgical and trauma intensive care unit to keep the blood pressure in the desired range. Initially, he was started on continuous veno-venous hemodialysis and later on transitioned to intermittent hemodialysis. He was switched back to peritoneal dialysis after 6 weeks of surgery.
CONCLUSIONS: Atypical presentation of a silent aortic dissection without chest pain in the setting of renal failure and other co-morbidities emphasizes that dialysis patients are different from the general population. Sometimes the management needs to be modified from the conventional ways to achieve the high level of success.
Keywords: Dissection, Hypertension, Peritoneal Dialysis, Uremia
In Press
18 Mar 2024 : Case report
Successful Endovascular Microembolization for Post-Traumatic High-Flow Priapism: A Case ReportAm J Case Rep In Press; DOI: 10.12659/AJCR.943467
19 Mar 2024 : Case report
Jejunal Diverticulosis Causing Small Intestinal Volvulus and Closed Loop ObstructionAm J Case Rep In Press; DOI: 10.12659/AJCR.943376
19 Mar 2024 : Case report
Excimer Laser Therapy for Pigmented Purpuric Dermatosis: A Case StudyAm J Case Rep In Press; DOI: 10.12659/AJCR.942853
19 Mar 2024 : Case report
Case Report: Primary Cutaneous Histoplasmosis in an Immunocompetent Patient After Cosmetic Injection of Pla...Am J Case Rep In Press; DOI: 10.12659/AJCR.942660
Most Viewed Current Articles
07 Mar 2024 : Case report
Neurocysticercosis Presenting as Migraine in the United StatesDOI :10.12659/AJCR.943133
Am J Case Rep 2024; 25:e943133
10 Jan 2022 : Case report
A Report on the First 7 Sequential Patients Treated Within the C-Reactive Protein Apheresis in COVID (CACOV...DOI :10.12659/AJCR.935263
Am J Case Rep 2022; 23:e935263
19 Jul 2022 : Case report
Atlantoaxial Subluxation Secondary to SARS-CoV-2 Infection: A Rare Orthopedic Complication from COVID-19DOI :10.12659/AJCR.936128
Am J Case Rep 2022; 23:e936128
23 Feb 2022 : Case report
Penile Necrosis Associated with Local Intravenous Injection of CocaineDOI :10.12659/AJCR.935250
Am J Case Rep 2022; 23:e935250