Via practica 1/2026
Acute aortic dissection: diagnostic challenges and clinical implications – a case report
Acute aortic syndrome (AAS) is a term used to describe a group of conditions characterized by the sudden injury of the aortic wall leading to its disruption or an increased risk of rupture. It was first defined in the 1990s to emphasize the shared clinical and diagnostic features of these entities. AAS includes three nosological units: aortic dissection, intramural hematoma (IMH) penetrating atherosclerotic ulcer (PAU). Aortic dissection is the most common and clinically the most severe form of AAS. It represents part of the same pathological spectrum in which acute injury to the aortic wall occurs. IMH and PAU are considered related entities that may exist independently, but may also represent progressive stages leading to dissection. The typical symptom is sudden, intense, tearing pain in the chest, back or abdomen. The pathological process results from an abrupt tear of the aortic intima, leading to separation of its layers and formation of a false lumen. The clinical presentation is often nonspecific and can mimic other emergency conditions, which significantly complicates the diagnostic process. The presented case highlights the importance of rapid clinical reasoning, timely indication for imaging studies, and effective multidisciplinary management. Despite advances in imaging and therapeutic methods, aortic dissection remains a condition associated with high mortality. This underscores the need for early recognition and an individualized therapeutic approach for each patient.
Keywords: aortic dissection, case report, emergency department
