Ischemic stroke as a comorbidity in a patient with Stanford A aortic dissection: A case report

Abstract

Background. Aortic dissection is one of the leading causes of death in cardiovascular disease. The clinical course of aortic dissection is often atypical and can mimic a variety of clinical manifestations. Stroke is one of the conditions that can make the management of aortic dissection becoming more complex. Case presentation. A 55-year-old female patient came with complaints of severe chest pain. The patient was diagnosed with Stanford aortic dissection, De Bakey type II, hypertension heart disease, mild mitral regurgitation, mild circumferential pericardial effusion. After the second day of treatment, the patient also complained of sudden slurred speech and weakness on right extremities. The administration of antiplatelet were postponed in consideration of the current patient with aortic dissection. On the 7th day of treatment, the patient experienced a worsening motor strength on the right extremities. We decided to continue antihypertensive therapy on acute phase of ischemic stroke with the consideration that aortic dissection can cause higher mortality. Conclusions. The management of ischemic stroke in a patient with aortic dissection is challenging. In ischemic stroke patient with aortic dissection, anti-hypertensives need to be given to reduce the stress on the aortic wall and prevent expansion of the dissection which has a higher mortality rate.