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In spite of the continuing efforts of researchers and practitioners, the mortality rate for acute type A aortic dissection remains relatively high at about 20-50%. Conventional risk factors associated with acute type A aortic dissection include a family history or prior history of aortic disease, connective tissue disease, smoking, alcohol use, substance abuse, diabetes mellitus type II, and age of 40 or greater. With the growing awareness for fitness in our society, vigorous exercise is emerging as a novel risk factor for acute type A Aortic dissection. Herein, we present a non-trauma related acute type A aortic dissection secondary to weight-lifting in a young man. We also reviewed several articles in order to provide a comprehensive literature overview for readers, clinicians and future researchers.

Aim:Aimed to evaluate the relationship of serum biochemical and blood parameters with aortic rupture and dissection types according to the DeBakey classification.Methods:Forty-three patients, who were admitted to the emergency department between 01.01.2011 and 01.01.2019 with the diagnosis of aortic dissection, were retrospectively evaluated. Gender, age, symptoms at presentation, vital parameters, creatinine and, troponin levels, and hemogram parameters were recorded after blood tests. Neutrophil-to-lymphocyte ratio and monocyte-to-platelet ratio were obtained from these values. These results were compared with the presence of aortic rupture and the DeBakey classification.Results:Of the 43 patients included in the study, 30 were male (69.8%), and 13 were female (30.2%). Aortic rupture was seen in two of the 30 male patients (6.7%) and none of the females (p=1.000). There was a significant difference only in blood urine nitrogen and monocyte-to-platelet ratio between patients with and without aortic rupture (p=0.035 and p=0.015, respectively).Conclusion:Most of the routinely evaluated blood and biochemical parameters in aortic dissection cases did not yield significant results in comparison to the DeBakey classification and the presence of rupture. Only blood urea nitrogen and monocyte-to-platelet ratio values were lower in patients with aortic rupture.

Aortic dissection is relatively uncommon, but often presents with acute severe chest or back pain and acute hemodynamic compromise and is associated with high mortality. We present a case of aortic dissection with an atypical presentation in a heart failure patient and the challenges encountered to make the diagnosis. The patient was a 54-year-old African American female who presented with progressively worsening exertional dyspnea and orthopnea for three days and sensation of indigestion and bloating. The patient denied any recent history of chest pain and she was initially admitted for heart failure exacerbation. Her admission chest x-ray showed severe cardiomegaly with a prominence of pulmonary vascular but there was a borderline widening of mediastinum measuring 8.2 cm. Physical exam showed unequal dorsalis pedis pulses (fainter on the right side) and systolic blood pressure difference of more than 20 mmHg between bilateral upper extremities. Computed tomography angiography (CTA) of chest, abdomen, and pelvis confirmed the diagnosis of dissection of thoracic and abdominal aorta extending from the left subclavian artery to the femoral artery. The patient was managed with labetalol drip and later transferred to a tertiary center for an elevated level of care where the endovascular intervention was performed. The patient then followed up with a vascular clinic for serial CTA and heart failure clinic for optimization of core measures. In conclusion, this case highlights the importance of clinical suspicion of aortic dissection and discusses the various clinical presentations of aortic dissection and its management. Being a highly fatal condition, prompt diagnosis is extremely important and is often life-saving. Therefore, it is important for physicians to be aware of atypical presentations of aortic dissection to initiate timely interventions to avoid catastrophic complications.

The authors present a case of syncope that was caused by aortic dissection. As the main artery to the system circulation, aortic dissection can manifest in numerous ways. This case reminds the clinician of the high index of suspicion necessary to diagnose this potentially life-threatening problem. Indeed, the mortality rate increases 2% per hour in the first 24 hours for a type A aortic dissection, so prompt diagnosis is imperative. The diagnostic complexity in this case is compounded by the very broad differential diagnosis for both aortic dissection and syncope.

Objective: Although acute aort dissection (AAD) is quite difficult to be diagnosed in the emergency department, the mortality of it is very high. Therefore, the purpose of our study is to discuss the evidence of demographic characteristics, clinical, laboratory of the AAD patients who applied to emergency department over mortality. Materials and Methods: In our research including 73 patients with AAD diagnosed whom admitted to emergency department on January 2010-October 2015. Sex, age, presenting complaints, past medical history, arterial blood pressure, pulse, laboratory tests, transthoracic echocardiography (TTE), thoracoabdominal computerized tomography (CT), mortality and DeBakey type have been recorded on patient information form. Statistical analysis was performed in IBM SPSS Statistics Version 22.0 software package. The comparison between the two groups of data Pearson chi-square, Fisher's exact and chi-square tests were used for statistical analysis of trends. P