Acute aortic dissection (AD) is one of important and crucial clinical problem due to difficulties of earlier diagnosis and high rate of severe adverse outcomes. It is known as part of acute aortic syndrome also including intramural hematoma, penetrating atherosclerotic ulcer, traumatic aortic injury, and aortic rupture. Acute AD is defined as disruption of the medial layer provoked by intramural bleeding, resulting in separation of the aortic wall layers and subsequent formation of a true lumen and a false lumen with or without communication. In most cases, an intimae tear is the initiating condition, resulting in tracking of the blood in a dissection plane within the media.
The article draws the attention of specialists to the problem of optimizing the diagnosis of the AD in a multidisciplinary hospital and demonstrates the advantages of the teamwork of related specialists, provides an analysis of the information significance of diagnostic methods according to literature data for 2014–2017, and the clinical case of successful early diagnosis and complex, including surgical, treatment of AD in a young patient.
The clinical case emphasizes that sudden pain in the chest, regardless of its location, in individuals over 40 years, especially in men, requires careful differential diagnosis to exclude acute cardiovascular conditions by specialists of any profile. Comprehensive examination and treatment of the patient helped to identify the RFs for AD: connective tissue dysplasia syndrome and hypertension.
Ischemic type of ECG changes in the in combination with periodic chest pain sent a diagnostic opinion towards acute coronary syndrome, however an additional examination by a team of specialists of a multidisciplinary hospital revealed another acute life-threatening condition — AD, and to do surgical treatment timely.