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INTRODUCTION. Cardiovascular disease is the main cause of death in most countries; aortic diseases contribute importantly to this mortality. Among these, aortic dissection is the pathology with the greatest potential of fatal outcomes and the most common cause of aortic rupture.
CASE REPORT. 60-year old male with unknown previous medical history, who came from a rural hospital with a 1-day history of retrosternal chest pain. The pain was oppressive, continuous, radiating to shoulders and left upper quadrant and an intensity of 7/10. At physical examination we found an arterial blood pressure of 130/80 mmHg on right arm and 90/40 mmHg on left arm. An aortic, III/VI murmur was heard on Erb’s accessory aortic focus irradiated to carotids, as well as a pericardial friction rub. He underwent abdominal aortic Doppler which showed the presence of flap inside the abdominal aorta.
DISCUSSION. The strategy for managing an aortic dissection has not been totally established and the guidelines are based fundamentally on expert recommendations, because more than one third of the patients are not diagnosed on time. Early diagnosis remains to be a major challenge, therefore is very important to keep in mind this pathology as a possible cause of chest pain.
