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An Atypical Case of Silent Aortic Dissection in a Peritoneal Dialysis Patient: A Case Report and Review of Literature
Journal article   Open access

An Atypical Case of Silent Aortic Dissection in a Peritoneal Dialysis Patient: A Case Report and Review of Literature

Waqas Javed Siddiqui, Ali Arif, Mohammad Harisullah Khan, Maryam Khan, Muhammad Owais Hanif, Muhammad Junaid Mahboob, Muhammad Aslam, Aysha Aslam, Hasan Arif and Sandeep Aggarwal
The American journal of case reports, v 19, pp 880-883
27 Jul 2018
DOI: https://doi.org/10.12659/AJCR.909966
PMID: 30050030
Featured in Collection :   UN Sustainable Development Goals @ Drexel
url
https://doi.org/10.12659/ajcr.909966View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open
url
https://doi.org/10.12659/AJCR.909966View
Published, Version of Record (VoR) Open

Abstract

Aneurysm, Dissecting - complications Aneurysm, Dissecting - diagnostic imaging Aneurysm, Dissecting - surgery Aortic Aneurysm - complications Aortic Aneurysm - diagnostic imaging Aortic Aneurysm - surgery Aortic Valve Insufficiency - diagnostic imaging Aortic Valve Insufficiency - etiology Humans Kidney Failure, Chronic - complications Kidney Failure, Chronic - therapy Male Middle Aged Peritoneal Dialysis Tomography, X-Ray Computed
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.

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3 citations in Web of Science
3 citations in Scopus

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#3 Good Health and Well-Being

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Collaboration types
Domestic collaboration
International collaboration
Web of Science research areas
Cardiac & Cardiovascular Systems
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