Case presentation
An 82-year-old female, autonomous in activities of daily living, with a history of arterial hypertension dyslipidemia, and chronic venous insufficiency medicated with Losartan 50mg/day Simvastatin 20mg/day and Daflon was admitted to the emergency department (ED) of the Luanda Medical Center because she woke up complaining of excruciating chest pain radiating to the back, associated with tiredness. A day earlier, he mentions that on an airplane trip, during the flight there was depressurization in the cabin, causing him a lot of stress and anxiety. Since then she started to feel chest discomfort.
On arrival at the ED, the patient was very complaining, tachypneic, respiratory rate = 28 cycles/min, Sat O2 87% in ambient air, rising to 93% with 3 L of O2 through nasal cannula. BP was 120/70 mmHg, with a pulse 70 bpm, and normal cardiac auscultation. Pulmonary auscultation: diminished vesicular sound with wheezes. Slight edema in the lower limbs. Peripheral pulses are present and symmetric.
Labs: Hb 10.0 g/L, D-dimers 32.199, values of CK-MB and troponine were normal. Blood gases: compensated respiratory acidosis with hypoxemia. Chest Rx (AP-view): Apparent widening of the mediastinum.Thoracic-abdominal CT angiography shows a Stanford type A AAD(Figure 1 A).The patient was referred for surgical treatment. The patient underwent surgical treatment (figure 1B,C), and she died on the 26th postoperative day due to respiratory failure